Invited commentary to: ‘Clinical pathways as a tool for process costing in cardiac surgery’ (Eur. Surg. 2003;35:51–54)

Summary

Background: By developing a standard clinical pathway, we tried to assess the cost of a coronary bypass procedure at our in institution in order to find possibilities for cost containment and financial decision-making.

Methods: A standard clinical pathway was designed for an aortocoronary bypass procedure. Using this pathway, we assessed the procedural costs in a stepwise manner for each individual patient to obtain the average cost for a bypass operation at our institution.

Results: Overall costs for a standard coronary bypass operation at our institution were 7,411 EUR. Costs for the surgical procedure, intensive care unit, intermediate care unit and 9 days on the ward were 3,722 EUR, 1,171 EUR, 271 EUR and 558 EUR, respectively. Expenses for personnel amounted to 3,194 EUR; for drugs, 78 EUR; for disposables, 2,919 EUR; for diagnostics, 274 EUR; and indirect costs, 609 EUR.

Conclusions: Standard clinical pathways are a valid means for assessing procedural costs. Making costs transparent is the basis for cost containment, benchmarking and financial decision-making in cardiac surgery.