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Complementary and integrative medicine - Resolving situations of reduced remuneration for additional work under the SwissDRG system.
Grass, Fabian; Berna, Chantal; Vogel, Charles-André; Demartines, Nicolas; Agri, Fabio.
Afiliación
  • Grass F; Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland.
  • Berna C; Center for Integrative and Complementary Medicine, Division of Anesthesiology, Department of Interdisciplinary Centers, Lausanne University Hospital, Lausanne, Switzerland.
  • Vogel CA; Department of Administration and Finance, Lausanne University Hospital, Lausanne, Switzerland.
  • Demartines N; Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland.
  • Agri F; General Direction, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland.
Heliyon ; 10(15): e34732, 2024 Aug 15.
Article en En | MEDLINE | ID: mdl-39157326
ABSTRACT
Aim of the study Complementary and integrative medicine (CIM) has been increasingly recognized as offering promising treatment adjunctions in various clinical settings, even amongst patients with serious, chronic, or recurrent illness. Today, only few tertiary care facilities in Switzerland offer dedicated CIM services for inpatients. The aim of the present study was to evaluate whether CIM services for complex medical conditions are adequately valued by the national inpatient SwissDRG reimbursement system.

Methods:

A simulation was performed by adding a specific code of the Swiss classification of interventions (CHOP) to the list of codes of each patient who received CIM therapies at the Lausanne University Hospital (CHUV) in 2021. This code is to be used when CIM services are provided. Hitherto, it was not entered due to a lack of specific documents justifying the resources used. The analysis focused on the impact of adding this CIM CHOP code on the Swiss Diagnosis Related Group (DRG) reimbursement.

Results:

In total, 275 patients received a CIM therapy in 2021. The addition of the CIM CHOP code 99.BC.12 (10-25 CIM sessions per stay) resulted in a simulated loss of income of CHF 766 630 for the hospital, while the net real result is already negative by more than CHF 6 million. The DRGs positively impacted by the addition of CIM CHOP code 99.BC.12 had a mean (SD) cost weight (CW) of 1.014 (0.620), while the DRGs negatively impacted had a mean (SD) CW of 3.97 (2.764) points.

Conclusion:

It is necessary to quickly react and improve the incentives contained in the grouping algorithm of the prospective payment system, whose effects can threaten the provision of adequate medical care to the patients despite suitable indications and potential for cost-savings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heliyon Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heliyon Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido