COST ACCOUNTING WORKGROUP

(members=health economists, health policy and clinician researchers, EOL

Care Project PI’s)

Stephen F. Seninger, Ph.D.

Workgroup Chair

RWJ Cost Accounting Workgroup-February 2002

The Problem

• How to accurately measure End-of-Life health care costs

• Within a complex, multi-sector health care ‘system’

• Where methods of ‘cost’ measurement vary depending on:: institutional environment, type of insurance, & reimbursement system

RWJ Cost Accounting Workgroup-February 2002

Regional VariationsIn Costs

Overhead and non-serviceCosts

Cost Shifting&

Monopoly Profits

Health Care Resources

Real Costs=Opportunity $Costs

Figure 1. Real & Observed Costs for End-of-Life Care

Observed$Costs

RWJ Cost Accounting Workgroup-February 2002

The Need

• Will improvements in care of dying

save health care system money?

• Does good End of Life Care Cost

More or Less?

RWJ Cost Accounting Workgroup-February 2002

Solutions & First Steps

• Identify methods and develop measurement tools for micro-costing

• Show how methods vary over different institutional environments

• Develop a data base and compendium of existing tools and disseminate information

RWJ Cost Accounting Workgroup-February 2002

Figure 2. Applied View of Health Care Production

Labor

Supplies

Equipment

Medical Technology

•Nursing Care•Tests•Laboratory/ X-ray•Medical Social Work•Physician Services•Counseling•Home Care•Inpatient Care•Outpatient Care•Respite Care•Medication•Therapy•Bereavement Services•Family /Personal Caregiving

•Palliative Care•Hospice

Resources/Inputs

Intermediate Products

Final Products

RWJ Cost Accounting Workgroup-February 2002

Products

• Position Paper in Spring, 2002

• Applied Practicum on Costing Methods for End of Life Healthcarewith case examples

• References on cost data sources

• Web Site & information from NPO