Setting up a reliable cost unit accounting system in a hospital is a fundamental necessity
for economic survival, given the current general conditions in the healthcare system.
Definition of a suitable cost unit is a crucial factor for success. We present here
the development and use of a clinical pathway as a cost unit as an alternative to
the DRG. Elective coronary artery bypass grafting was selected as an example. Development
of the clinical pathway was conducted according to a modular concept that mirrored
all the treatment processes across various levels and modules. Using service records
and analyses the process algorithms of the clinical pathway were developed and visualized
with CorelTM iGrafix® Process 2003. A detailed process cost record constituted the
basis of the pathway costing, in which financial evaluation of the treatment processes
was performed. The result of this study was a structured clinical pathway for coronary
artery bypass grafting together with a cost calculation in the form of cost unit accounting.
The use of a clinical pathway as a cost unit offers considerable advantages compared
to the DRG or clinical case. The variance in the diagnoses and procedures within a
pathway is minimal, so the consumption of resources is homogeneous. This leads to
a considerable improvement in the value of cost unit accounting as a strategic control
instrument in hospitals.
Cost calculation - cost unit - clinical pathway - cardiac surgery - CABG - DRG
