Inpatient hospital costs and length of stay for the treatment of affective and somatoform disorders - evidence from Germany

Abstract

Introduction: Diagnosis related costs analyses are the subject of science and research and are of great relevance and importance for decision makers in the hospital and for funding bodies, but also for international health policy. Up to now, standardized costs analyses with valid costs data have not been available for inpatient care of patients with affective and somatoform disorders.

Background: This clinical picture presents a major challenge for the provision of outpatient and inpatient care. An interdisciplinary approach in an inpatient setting can be beneficial for already "chronified" patients with severe forms of progression. Because of its structural and procedural demands, this type of care is associated with a greater expenditure of resources.

Methods: Costs data from the years 2008 to 2012 were analyzed for a total of 17,424 hospitalized patients in more than 200 different hospitals in Germany. The study compared the costs of treating patients with the main diagnosis affective and somatoform disorders using standardized interdisciplinary therapy, with the costs of conventional therapy.

Results: Interdisciplinary patient care is characterized by a high proportion of the costs derived from the structural and procedural implementation and the medical and nursing care. For interdisciplinary therapy with a mean period of hospitalization of 15.2 days, over 60% of the total costs were incurred by the personnel and material costs of the medical and non-medical infrastructure. The outlay is considerably greater than would be incurred by a conventional therapeutic approach without interdisciplinary therapy.

Discussion and conclusion: For the first time, detailed diagnosis-related costs data are published which were generated by consistent, standardized cost unit accounting. An interdisciplinary, holistic approach to the clinical picture results in a significant increase in costs for the hospitals.

Keywords: affective disorders; diagnosis-related costs; inpatient costs analyses; interdisciplinary approach; multimodal pain therapy; somatoform disorders.

Figure 1

Overview of the calculation steps for determining the DRG-relevant case costs, of InEK. Abbreviations: DRG, Diagnosis Related Group; InEK, Institute for the Hospital Reimbursement System.