A comparison of actual cost, DRG-based cost, and hospital reimbursement for liver transplant XXXX .

@entity1 @entity11963
The financing of health care services in Norway has been changed from a system of global budgeting to a system partly based on Diagnosis-Related Groups (DRG). The government has decided to derive a part of the hospital revenue from DRG-based, per- @entity1 financing. The aim of this study is to determine whether the present remuneration system covers the actual hospital expenses of liver transplant @entity1 , and whether the present method of calculating DRG-costs is adequate for our institution. Our group developed a prospective method of determining the actual cost per @entity1 . We closely observed and collected the data of eight liver transplant @entity1 during their hospital stay. We divided each of the @entity1 ' resource requirements into four categories; heavy intensive care, light intensive care, intermediate care, and ordinary care. In addition, we recorded the number of staff involved, the duration of surgery, the major procedures, and the medical- and material costs. The actual cost of each @entity1 was calculated, based on these data. The actual cost was compared with the corresponding hospital remuneration for each @entity1 . Median cost for liver transplantation was @entity11963 536.785 (range: @entity11963 295.113- @entity11963 844.345) (1 =7,5 @entity11963 ), while the corresponding hospital refund was @entity11963 457.785 (range: @entity11963 436.465- @entity11963 483.040). The difference is not statistically significant ( P=0.2). The average 100% DRG-based cost of a liver transplantation was @entity11963 730.321, which is significantly higher than the actual cost ( P=0.02). The hospital's reimbursement for liver transplantation did not differ significantly from the actual registered cost. The computed cost was significantly lower than the DRG-based cost.
