On-call neurosurgery: can this continue as a free service?
| Autor: | N. J. Johnston, D. T. Holsgrove, J. R. S. Leggate |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Emergency Medical Services Tariff Neurosurgical Procedures State Medicine Unit (housing) After-Hours Care medicine Humans Neurosurgical department Referral and Consultation health care economics and organizations Service (business) business.industry Financing Organized General Medicine Health resource National health service medicine.disease Hospital Charges United Kingdom Payment by Results Costs and Cost Analysis Surgery Neurology (clinical) Neurosurgery Medical emergency business Delivery of Health Care |
| Zdroj: | British journal of neurosurgery. 25(4) |
| ISSN: | 1360-046X |
| Popis: | Since 2005, Acute National Health Service (NHS) Trusts have been funded using a system called Payment by Results. This provides a national or regionally set tariff per patient treated, according to a health resource group code. Health resource group codes vary according to diagnosis or procedures carried out and patient co-morbidities. This only funds trusts admitting patients rather than those advising remotely, as neurosurgical centres do for the majority of emergency referrals. Numbers of referrals and emergency admissions to our unit were analysed for the last 4 years in addition to consultant and secretarial time devoted to these cases. This demonstrated an increase in the number of referrals and time spent advising. For the trust hosting the neurosurgical department, this represents a funding deficit for services offered. In our region, this has been remedied by charging neighbouring trusts a fee for emergency neurosurgical referral advice. However, this is difficult to administrate and would be better served as a service-level agreement with our commissioners. Only when this has been achieved, can neurosurgical centres provide a comprehensive consultant-led emergency service without it being to the detriment of the host trust. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
| Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |