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Assessing the opportunity costs of patients with multidrug-resistant organisms in hospitals

Author

Listed:
  • Claudia Hübner

    (University of Greifswald)

  • Walter Ried

    (University of Greifswald)

  • Steffen Flessa

    (University of Greifswald)

Abstract

Objectives The concept of opportunity cost can be applied to the utilization of hospital beds with special focus on patients colonized or infected with multidrug-resistant organisms. Blocked beds due to isolation measures or increased length of stay may result in opportunity costs if newly arriving patients have to be rejected and the hospital is confronted with revenue foregone. However, the amount of these costs is unclear, since different approaches are used in the literature to determine the respective costs. Our paper develops a concept to assess opportunity costs from the perspective of a hospital. Methods The analysis is two-stage. In a first step, the probability of rejecting a patient due to over-occupancy in a hospital is calculated with a queuing model and a Monte Carlo simulation taking various assumptions into account. In a second step, the amount of the opportunity costs is calculated as an expected value applying a stochastic approach based on a potential patient pool. Results Opportunity costs will occur only with a probability that is influenced, among others, by current bed occupancy rates. They have to be measured by average net revenue foregone, i.e., by the difference between average revenue foregone and average costs avoided. Conclusions Previous studies have a tendency of overestimating the occurrence or the size of opportunity costs with regard to the use of hospital beds. Nonetheless, its influence on the hospital budget is crucial and should be determined exactly.

Suggested Citation

  • Claudia Hübner & Walter Ried & Steffen Flessa, 2018. "Assessing the opportunity costs of patients with multidrug-resistant organisms in hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(7), pages 1009-1017, September.
  • Handle: RePEc:spr:eujhec:v:19:y:2018:i:7:d:10.1007_s10198-017-0949-8
    DOI: 10.1007/s10198-017-0949-8
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    Keywords

    Opportunity costs; Hospital; Net revenue foregone; Monte Carlo simulation; Decision-making; Multidrug-resistant organisms;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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