Nord Med. 1989;104(5):145-6, 160.
Nordisk medicin
[Article in Swedish] J Ahlmén
PMID: 2499868
Measurements of productivity and effectiveness in health care are often inadequate. The number of haemodialyses performed is the most commonly used measure of the productivity of a dialysis unit, and is also the basis for economic calculations irrespective of differences in the degree of complications between cases. The result is marked discrepancies in the cost per dialysis between different haemodialysis units. The concept, calculated dialysis time (CDT), was involved in an attempt to estimate the different activities associated with an uncomplicated versus a complicated dialysis. A complicated four-hour dialysis might thus represent a maximum of seven hours CDT. A measure of productivity was obtained when CDT was related to total staff time expended. The total costs of dialysis divided by CDT is a better way of arriving of the cost per dialysis than many routine estimations in current use. Two hospital dialysis units were compared, Falköping (BSF) and Skövde (KSS), during a 22-week period in 1986. Productivity was 24 per cent higher at KSS than at BSF when effective dialysis time alone was related to staff time, but 31 per cent higher at KSS when the CDT was used. This increase in productivity was obtained at an increased cost of only 20 per cent. The wide fluctuation in workload in a dialysis unit necessitates good adaptation vis-à-vis changes in dialysis time and staff time. By integrating dialysis unit staff and dialysis-trained staff at other departments it is suggested that hospital haemodialysis productivity can be increased at reasonable cost.
