Medico-economic analysis of a neurosurgery department at a university hospital

Analyse médico-économique d'un service de neurochirurgie en centre hospitalier et universitaire

Jean-Jacques Lemaire (jjlemaire@chu-clermontferrand.fr), Cyril Delom, Aurélien Coste, Toufic Khalil, Jean-Christophe Jourdy, Bénédicte Pontier, Jean Gabrillargues, Denis Sinardet, Abdelkader Chabanne, Viorel Achim, Laurent Sakka, Jerome Coste (jerome.coste@uca.fr), Jean Chazal, André Salagnac, Guillaume Coll (gcoll@chu-clermontferrand.fr) and Bernard Irthum
Additional contact information
Jean-Jacques Lemaire: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Cyril Delom: Direction des Finances - CHU Clermont-Ferrand
Aurélien Coste: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Toufic Khalil: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Jean-Christophe Jourdy: DIM - Département d'Information Médicale [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Bénédicte Pontier: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Jean Gabrillargues: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Denis Sinardet: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Abdelkader Chabanne: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Viorel Achim: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Laurent Sakka: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Jerome Coste: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Jean Chazal: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
André Salagnac: DRCI - Direction de la Recherche Clinique et de l’Innovation [CHU Clermont-Ferrand] - CHU Clermont-Ferrand
Guillaume Coll: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand
Bernard Irthum: Service Neurochirurgie A et B [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand - MNDO - Pôle Médecine interne, Neurologie, Neurochirurgie, Ophtalmologie [CHU Clermont-Ferrand] - CHU Gabriel Montpied [Clermont-Ferrand] - CHU Clermont-Ferrand

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Abstract: Objective: Economic and societal constraints require to take into account the economic dimension and medical performance of hospital departments. We carried out a self-assessment study, which we thought could be useful to share with the neurosurgical community. Material and methods: Care and research activities were assessed from 2009 to 2013. We used institutional and assessment-body parameters in order to describe activities and perform a financial evaluation. It was a retrospective descriptive study based on the guidelines of the DHOS/O4 circular No. 2007/390 of October 29, 2007. Results: The average annual, analytic income statement was + 1.39 millions euros, for 63 beds with a 92% occupancy rate, including 6.7 full-time equivalent neurosurgeons (and assistants), for 2553 patients and 1975 surgeries. The average mortality rate was 2.74%. The annual mean length of stay was 6.82 days. Per year, on average 15.6% of patients were admitted in emergency and 76.9% returned home. The annual, act-related-pricing and publication-related incomes represented 77% and 0.6%, respectively of the total funding. Difficulties to find downstream beds for the most severe patients induced 1401 "waiting days" in 2012. Conclusion: Medico-economic analysis of a neurosurgery department at a university hospital was useful in order to take into account the care, teaching and research activities, as well as its related financial value.

Keywords: Research; Care; Neurosurgery; Economy; Assessment; Performance; Neurochirurgie; Soin; Recherche; Économie; Évaluation (search for similar items in EconPapers)
Date: 2015
Note: View the original document on HAL open archive server: https://uca.hal.science/hal-01558825
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Published in Neurochirurgie, 2015, 61 (1), pp.2-15. ⟨10.1016/j.neuchi.2014.11.011⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01558825

DOI: 10.1016/j.neuchi.2014.11.011

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