Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review
Abstract Background The rising cost of healthcare is a concerning issue for healthcare systems. The Diagnosis Related Group (DRG) system lacks direct consideration for costs related to nursing care. Therefore, to date there is no clear picture of billing models that consider also nursing activity wh...
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BMC
2025-01-01
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| Online Access: | https://doi.org/10.1186/s12913-024-12116-3 |
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| author | Marco Di Nitto Francesca Napolitano Michela Calzolari Yari Longobucco Vittorio Masotta Francesco Zaghini Rosaria Alvaro Giancarlo Cicolini Loreto Lancia Duilio Fiorenzo Manara Laura Rasero Gennaro Rocco Maurizio Zega Beatrice Mazzoleni Loredana Sasso Annamaria Bagnasco |
| author_facet | Marco Di Nitto Francesca Napolitano Michela Calzolari Yari Longobucco Vittorio Masotta Francesco Zaghini Rosaria Alvaro Giancarlo Cicolini Loreto Lancia Duilio Fiorenzo Manara Laura Rasero Gennaro Rocco Maurizio Zega Beatrice Mazzoleni Loredana Sasso Annamaria Bagnasco |
| author_sort | Marco Di Nitto |
| collection | DOAJ |
| description | Abstract Background The rising cost of healthcare is a concerning issue for healthcare systems. The Diagnosis Related Group (DRG) system lacks direct consideration for costs related to nursing care. Therefore, to date there is no clear picture of billing models that consider also nursing activity when evaluating healthcare service costs or what factors related to nursing care affect the costs of healthcare services and would therefore need to be considered in billing models. Methods A scoping review was conducted. We searched articles published from January 2000 to September 2023, in English, Italian and Spanish. We consulted MEDLINE (Pubmed), CINAHL (EBSCOhost), Web of Science (Clarivate), SCOPUS (Elsevier), ProQuest and Google Scholar, government sites and major international bodies (e.g., National Health Service NHS, World Health Organization WHO). Results We included a total of 31 studies. The results highlighted 3 categories of factors related to nursing costs, which involve the organisation (e.g., nurse-to-patient ratio), nurses (e.g., skill mix, interventions), and patients (e.g., patient complexity, patient outcomes). All the billing models reported in the literature considered one or more of these categories to estimate nursing costs. The results also showed that appropriate management of organisational and nursing factors, such as staffing and skill mix, could improve healthcare service costs, nursing care or practice, and patient outcomes. Conclusions This study sheds light on the multifaceted aspects of nursing care that should be considered in a specific, comprehensive, billing model. Additional testing of existing models to verify their effectiveness, as well as the organisation of a permanent committee (or Task Force) that develops a comprehensive billing model, are necessary to guide the formulation of new policies. |
| format | Article |
| id | doaj-art-0a77c1221f4140369889e1e3cdd9ebbc |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-0a77c1221f4140369889e1e3cdd9ebbc2025-01-19T12:15:23ZengBMCBMC Health Services Research1472-69632025-01-0125112310.1186/s12913-024-12116-3Billing models for measuring nursing care in inpatient and outpatient settings: a scoping reviewMarco Di Nitto0Francesca Napolitano1Michela Calzolari2Yari Longobucco3Vittorio Masotta4Francesco Zaghini5Rosaria Alvaro6Giancarlo Cicolini7Loreto Lancia8Duilio Fiorenzo Manara9Laura Rasero10Gennaro Rocco11Maurizio Zega12Beatrice Mazzoleni13Loredana Sasso14Annamaria Bagnasco15Department of Health Sciences, University of GenoaDepartment of Health Sciences, University of GenoaDepartment of Health Sciences, University of GenoaDepartment of Health Sciences, University of FlorenceDepartment of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’AquilaDepartment of Biomedicine and Prevention, University of Rome Tor VergataDepartment of Biomedicine and Prevention, University of Rome Tor VergataDepartment of innovative technologies in medicine & dentistry, “G. D’annunzio” University of Chieti-PescaraDepartment of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L’AquilaFaculty of Medicine and Surgery, Vita-Salute San Raffaele UniversityDepartment of Health Sciences, University of FlorenceCentre of Excellence for Nursing Scholarship, c/o Order of Nursing Professions (OPI) of RomeFatebenefratelli Isola Tiberina, A.Gemelli IRCCS University Hospital FoundationHumanitas UniversityDepartment of Health Sciences, University of GenoaDepartment of Health Sciences, University of GenoaAbstract Background The rising cost of healthcare is a concerning issue for healthcare systems. The Diagnosis Related Group (DRG) system lacks direct consideration for costs related to nursing care. Therefore, to date there is no clear picture of billing models that consider also nursing activity when evaluating healthcare service costs or what factors related to nursing care affect the costs of healthcare services and would therefore need to be considered in billing models. Methods A scoping review was conducted. We searched articles published from January 2000 to September 2023, in English, Italian and Spanish. We consulted MEDLINE (Pubmed), CINAHL (EBSCOhost), Web of Science (Clarivate), SCOPUS (Elsevier), ProQuest and Google Scholar, government sites and major international bodies (e.g., National Health Service NHS, World Health Organization WHO). Results We included a total of 31 studies. The results highlighted 3 categories of factors related to nursing costs, which involve the organisation (e.g., nurse-to-patient ratio), nurses (e.g., skill mix, interventions), and patients (e.g., patient complexity, patient outcomes). All the billing models reported in the literature considered one or more of these categories to estimate nursing costs. The results also showed that appropriate management of organisational and nursing factors, such as staffing and skill mix, could improve healthcare service costs, nursing care or practice, and patient outcomes. Conclusions This study sheds light on the multifaceted aspects of nursing care that should be considered in a specific, comprehensive, billing model. Additional testing of existing models to verify their effectiveness, as well as the organisation of a permanent committee (or Task Force) that develops a comprehensive billing model, are necessary to guide the formulation of new policies.https://doi.org/10.1186/s12913-024-12116-3Nursing costsNursing billing modelsNursing economic evaluationHealth care service |
| spellingShingle | Marco Di Nitto Francesca Napolitano Michela Calzolari Yari Longobucco Vittorio Masotta Francesco Zaghini Rosaria Alvaro Giancarlo Cicolini Loreto Lancia Duilio Fiorenzo Manara Laura Rasero Gennaro Rocco Maurizio Zega Beatrice Mazzoleni Loredana Sasso Annamaria Bagnasco Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review BMC Health Services Research Nursing costs Nursing billing models Nursing economic evaluation Health care service |
| title | Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review |
| title_full | Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review |
| title_fullStr | Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review |
| title_full_unstemmed | Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review |
| title_short | Billing models for measuring nursing care in inpatient and outpatient settings: a scoping review |
| title_sort | billing models for measuring nursing care in inpatient and outpatient settings a scoping review |
| topic | Nursing costs Nursing billing models Nursing economic evaluation Health care service |
| url | https://doi.org/10.1186/s12913-024-12116-3 |
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