Evidence map›Paper›PMID 27809933›Full record

ArticleEuropean journal of medical research2016

Is it time to rebalance the case mix? A portfolio analysis of direct catheterization laboratory costs over a 5-year period.

Gunnar Plehn, Thomas Butz, Petra Maagh, Ahmet Oernek, Axel Meissner, Natalie Plehn

Abstract read
In one paragraph

Article in European journal of medical research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gunnar PlehnDepartment of Cardiology, Johanniter-Hospital Duisburg Rheinhausen, Germany, Kreuzacker 1-7, 47228, Duisburg, Germany. gunnar.plehn@rub.de.
Thomas ButzDepartment of Cardiology, Catholic Hospital Oberhausen, Wilhelmstrasse 34, 46145, Oberhausen, Germany.
Petra MaaghRuhr-University of Bochum, Universitätsstrasse 150, 44801, Bochum, Germany.
Ahmet OernekDepartment of Radiology, University Hospital Bergmannsheil Bochum, Bürkle de la Camp-Platz 1, 44789, Bochum, Germany.
Axel MeissnerRuhr-University of Bochum, Universitätsstrasse 150, 44801, Bochum, Germany.
Natalie PlehnSchumpeter School of Business and Economics, University of Wuppertal, Gaussstrasse 20, 42119, Wuppertal, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac catheterization laboratories (CLL) have continued to function as profit centers for hospitals. Due to a high percentage of material and labor costs, they are natural targets for process improvement. Our study applied a contribution margin (CBM) concept to evaluate costs and cost dynamics over a 5-year period.

methodsWe retrospectively analyzed all procedures performed at a tertiary heart center between 2007 and 2011. Total variable costs, including labor time, material, and maintenance-expenses, were allocated at a global as well as a procedural level. CBM and CBM ratios were calculated by integration of individual DRG revenues.

resultsAnnual case volume increased from 1288 to 1545. In parallel, overall profitability improved as indicated by a 2% increase in CBM ratio and a higher CBM generated per hour of CLL working time (4325 vs. 5892 €, p < 0.001). Coronary angiography generated higher average CBMs per hour than coronary or electrophysiological interventions (5831 vs. 3458 vs. 1495 €; p < 0.001). The latter are characterized by relatively high per case material expenditures. On a procedural level, DRG-specific trends as a steady improvement of examination time or an increase in material costs were detectable.

conclusionsThe CBM concept allows a comprehensive analysis of CLL costs and cost dynamics. From a health service providers view, its range of application includes global profitability analysis, portfolio evaluation, and a detailed cost analysis of specific service lines. From a healthcare payers perspective, it may help to monitor hospital activities and to provide a solid data basis in cases where inappropriate developments are suspected. The calculation principle is simple which may increase user acceptance and thus the motivation of team members.

Indexed as

Cardiac CatheterizationCoronary AngiographyCost-Benefit AnalysisCosts and Cost AnalysisGermanyHumansRetrospective StudiesTertiary Care CentersCardiac catheterization laboratoryContribution marginCost analysisProcedural portfolio analysis

Identifiers

PMID27809933
PMCPMC5094137

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