EVALUATION OF THE OPERATING COSTS OF THE MEDICAL ACTIVITY (STUDY IN THE FRAMEWORK OF THE BELGIAN HOSPITAL FINANCING REFORM PLAN ADOPTED IN 2015), THE EXAMPLE OF NEUROSURGERY

Abstract

The objective of this study was to assess the operating costs of medical procedures performed for clusters with low and medium variability, in order to prepare the possible phase of fees splitting, which is planned in the Belgian hospital financing reform. A selection of 355 medical procedures, corresponding to the medical procedures representing 80% of the costs of the procedures performed for stays grouped in APR-DRGs with low or medium variability was carried out. The operating costs of procedures are defined as the cost of the medical or technical staff directly involved in the procedure, the cost of the medical consumables not invoiced, the cost of the equipment and of the small equipment necessary for carrying out the procedure. The study was carried out in a sample of 14 Belgian hospitals. It was necessary to combine different methodologies, in order to adapt to the availability or not availability of data in hospitals. This study was useful because it made possible to analyse concretely the methodological difficulties, which will have to be solved if the ministry wants to split fees, combining actually professional fees and operating costs. However, this stage is conditioned by a structural reform of the medical nomenclature.