Health Services Expenditure

Tuesday, 24 June 2014

Questions (661)

Billy Kelleher

Question:

661. Deputy Billy Kelleher asked the Minister for Health the direct cost of doctors, hospital services, medications and so on by year, of coronary bypass surgery to the Irish health care system; and if he will make a statement on the matter. [27362/14]

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Written answers

Minister for Health

Information on hospital discharges is available from the Hospital Inpatient Enquiry (HIPE) which covers all inpatient and daycase activity in publicly funded acute hospitals in the State.

While all patients are unique, groups of patients have demographic, diagnostic and therapeutic attributes in common that determine their level of resource intensity. By developing clinically similar groups of patients with similar resource intensity, patients can be aggregated into meaningful patient classes. Patients are classified using an internationally recognised system of Diagnostic Related Groups (DRGs).

There are 698 separate DRGs and each one defines a homogenous category with respect to clinical and diagnostic care and resource requirement. DRG assignment is based on a series of factors including: age, sex, principal diagnosis, secondary diagnosis, procedures performed and the discharge status.

The Deputy’s question refers to coronary bypass surgery. The activity and the associated costs related to coronary bypass surgery are captured by two DRGs. The most recent data on the activity and the average cost for a patient falling into these DRGs is set out in the table.

Year	DRG	Abbrev DRG	DRG Partition	All HIPE Inpatient Cases	Cost Per Case (€)
2010	F06A	Coronary Bypass W/O Invasive Cardiac Inves W Catastrphic or Severe CC	Surgical	462	29,367
2010	F06B	Coronary Bypass W/O Invasive Cardiac Inves W/O Catastrphic or Severe CC	Surgical	234	20,565
2011	F06A	Coronary Bypass W/O Invasive Cardiac Inves W Catastrphic or Severe CC	Surgical	433	27,317
2011	F06B	Coronary Bypass W/O Invasive Cardiac Inves W/O Catastrphic or Severe CC	Surgical	266	20,064
2012	F06A	Coronary Bypass W/O Invasive Cardiac Inves W Catastrphic or Severe CC	Surgical	448	23,830
2012	F06B	Coronary Bypass W/O Invasive Cardiac Inves W/O Catastrphic or Severe CC	Surgical	207	19,301

Notes: The value and figures quoted relate to inpatient cases only. W– with; W/O –without; CC—Complication or Comorbidity

The costs outlined are full costs including direct costs and an allocation of relevant hospital overheads. The cost relates to the inpatient stay only and does not include the cost of pre and post admission Outpatient Clinics, or attendance at the Emergency Department if appropriate. The cost also excludes Capital and Depreciation Costs. It should be noted that the medication costs included in the cost are in-hospital administered medications only. Prescriptions and follow-up medications related to maintaining patients out of hospital are not included in this costing.