Student Dissertation

Agency : Health Checkup; OP Diagnostic; Turn Around Time; CABG Package; Billing Process

Objective : ï‚· To study actual bills and estimate of CABG procedure in detail. ï‚· To list out the critical components contributing in deviation from estimate to actual.

Background : Wockhardt Heart Hospital, Nagpur is a 48 bedded (12 ICU and 5 SICU) cardiac care unit which performs all kinds of critical cardiac surgeries. It has full time expert team of cardiologists and cardiac surgeons to drive its cardiac services. It is one of the pioneers of Angiography by the radial method. Apart from other procedures it does around 250 CABG procedures in a year. Before any surgery or clinical procedure, estimate is the primary mode to make patient understand that how much they need to spend on a particular procedure and if there is any fluctuation, it ultimately leads to patient dissatisfaction.

Methodology : a. Type of study: Retrospective mode of study b. Location of study: Wockhardt Heart Hospital, Nagpur c. Study subjects: CABG actual bills and estimate d. Sampling process: Simple Random Sampling e. Sample Size: 100 f. Data (information) to be collected: Primary data: CABG actual bills from Hospital Information System. Secondary data: Books, Journals, Internet. g. Data collection tools: quantitative

Findings : ï‚· In case of analysis of cash bills, it was found that 26 % of the total bills were exceeding the estimate (if we take also as 8-10 days) ï‚· After this, we did critical analysis of these 26 % bills and the results were as follows: ï‚· Maximum deviation was due to investigations done. ï‚· In investigations done, blood gas analysis was most critical. ï‚· Bed rentals was also one of the critical components. ï‚· Average ICU stay was 3 days. ï‚· In case of analysis of credit bills, it was found that 48 % of total bills were exceeding the estimate. 94 ï‚· In critical analysis of these 48 % bills, components which were responsible for deviation were as follows: ï‚· (i). Investigations done (blood gas analysis and blood transfusion). ï‚· (ii). Consumables. ï‚· In both the cases i.e. cash as well as credit, variation in twin sharing was more than multi bed and single bed.

Recommendations : ï‚· ICU stay can be increased in the package by one day i.e. 3 days from 2 days. ï‚· Length of stay in package can be increased from 8 days to 10 days. ï‚· The data collected was kept confidential and anonymous. ï‚· The data collected was used for research purposes.