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Cost and financing of comprehensive care

From Ike Bomer, Kempenhaege, Netherlands

Berlin (20. September 2008) – It is difficult to identify what are the real costs of a certain activity “A” in a hospital. In many cases a hospital does not even know exactly what the costs of “A” are and besides that, one often “interchanges” the costs of “A” and the reimbursement that the hospital receives for “A” from the insurance company. There can be big differences between that, for example in those countries, where the accommodation of the hospital is paid apart by the state or where patients themselves have to pay directly a part of the reimbursement.

A second problem in determining costs of comprehensive epilepsy care is that there are always more institutes involved in comprehensive care. As it is difficult to determine the real costs of one organization in such a chain of activities, it is still more difficult to determine the total costs of the whole chain!

In general comprehensive epilepsy care will be more expensive than non-comprehensive. That is why it is important to avoid comprehensive care in cases which do not request this kind of care. On the other side it is also important that a patient who needs comprehensive care receives this as soon as possible. If one tries to avoid comprehensive care for people who need this, one takes a risk, consisting of ‘’shopping’’, of false decisions, of non-complete information and so on. Sometimes this brings very bad implications for the patients and at the end very high, often avoidable costs.

So the finance system should stimulate the right choice: comprehensive care or not.

Of course the costs of a product or a service always have to be compared with the benefits of it.

Comprehensive epilepsy care may cost a lot, but the positive effects of it – not only in terms of quality of life but also in pure financial terms can be so big, that in many cases it is far more profitable than non-comprehensive care.

There is an important restriction: comprehensive epilepsy care is only useful if the quality is guaranteed. Bad comprehensive care causes a lot of misery for the patient and a lot of unnecessary costs.

So the message is: comprehensive epilepsy care is more expensive than non-comprehensive. So be critical in the decision to refer to it. But if it is necessary there is a good chance for a huge benefit! Next you have to be critical in choosing a partner for comprehensive epilepsy care for reasons of quality.

The West-European Epilepsy Centres in general offer comprehensive care of good quality. The costs of their care usually are more explicit and far lower than in the case of comprehensive care by a chain of different organizations.

Source: 8th European Congress on Epiteptology, Satellite Symposium: “Comprehensive Care of Epilepsy in Europe”, Berlin, 20. September 2008 (Medizin und PR Kommunikation).