Written answers

Tuesday, 24 June 2014

Department of Health

Health Services Expenditure

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
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661. To ask 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]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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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.

YearDRGAbbrev DRGDRG PartitionAll HIPE Inpatient CasesCost Per Case (€)
2010F06ACoronary Bypass W/O Invasive Cardiac Inves W Catastrphic or Severe CCSurgical46229,367
2010F06BCoronary Bypass W/O Invasive Cardiac Inves W/O Catastrphic or Severe CCSurgical23420,565
2011F06ACoronary Bypass W/O Invasive Cardiac Inves W Catastrphic or Severe CCSurgical43327,317
2011F06BCoronary Bypass W/O Invasive Cardiac Inves W/O Catastrphic or Severe CCSurgical26620,064
2012F06ACoronary Bypass W/O Invasive Cardiac Inves W Catastrphic or Severe CCSurgical44823,830
2012F06BCoronary Bypass W/O Invasive Cardiac Inves W/O Catastrphic or Severe CCSurgical20719,301
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.

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