Unit Costs of Inpatient Hospital Days

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Abstract
Background: Costs of inpatient days in hospitals are frequently the main drivers of total treatment costs, and their unit cost can markedly affect the outcomes of an economic evaluation. In many countries, the availability of unit cost data is limited and unit costs are often based on data from hospitals participating in clinical trials. Objective: To provide data about unit costs of inpatient hospital days in The Netherlands from a healthcare provider’s perspective and to give an insight into the extent to which cost categories and total costs differ between hospitals. Design: Unit costs were collected from 22 wards and 11 intensive care units (ICUs) of general and university hospitals involved in clinical trials with ‘piggy-backed’ economic evaluations. Direct costs, such as costs of nursing and medical materials, were calculated by dividing the annual cost per category of the nursing department by the annual number of inpatient days. Indirect costs, such as overheads and accommodation, were allocated to the nursing departments by applying direct allocation. All costs were expressed in 1998 euros (EUR). Results: The mean costs per inpatient day were EUR230 (range: EUR154–EUR311) in general hospitals and EUR323 (range: EUR209–EUR400) in university hospitals. The mean costs per inpatient day in an ICU were EUR1125 (EUR919–EUR1560). Between 38–48% of the total costs were made up of nursing costs. All cost categories showed wide variations between hospitals. Conclusions: The results of this study were used to develop standard costs for inpatient days in The Netherlands and may contribute to the comparability and generalisability of economic evaluations.