Costs of Measuring Outcomes of Acute Hospital Care in a Longitudinal Outcomes Measurement System

It is widely acknowledged that the measurement of outcomes of care
and the comparison of outcomes over time within health care
providers and risk-adjusted comparisons among providers are
important parts of improving quality and cost-effectiveness of
care. However, few studies have assessed the costs of measuring
outcomes of care. We sought to evaluate the personnel and financial
resources spent for a prospective assessment of outcomes of acute
hospital care by health professionals in internal medicine. The
study included 15 primary care hospitals participating in a
longitudinal outcomes measurement program and 2005 patients over an
assessment period with an average duration of 6 months. Each
hospital project manager participated in a previously-tested
structured 30-minute telephone interview. Outcome measures include
time spent by the individual job titles in implementing and running
the outcomes measurement program. Job-title-specific times were
used to calculate costs from the hospitals' perspective. One-time
costs (C2132 + 1352) and administrative costs (95 97 per week)
varied substantially. Costs per patient were fairly stable at
around 20. We estimated that the total cost for each hospital to
assess outcomes of care for accreditation (10 tracer diagnoses over
6 months) would be 9700 and that continuous monitoring of outcomes
(5 tracer diagnoses) would cost 12,400 per year. This study
suggests that outcomes of acute hospital care can be assessed with
limited resources and that standardized training programs would
reduce variability in overall costs. This study should help
hospital decision makers to estimate the necessary funding for
outcomes measurement initiatives.