England | DRG | Cost | Complex, Cataract or Lens Procedures, with CC Score 0–1 (1,374£), Very Major, Cataract or Lens Procedures, with CC Score 0–1 (1,064£), Intermediate, Cataract or Lens Procedures, with CC Score 0–1 (957£)(8) | 2018 | Reference costs come from hospital accounting. They include all direct costs, variable overheads and fixed overheads (except teaching cost and research cost). | Top-down micro-costing. The production costs refer to a day case cataract surgery. In order to produce 2016/2017 reference costs, all costs and resources are collected from 2017/2018 and are analysed in 2018/2019. |
Tariff | Complex, Cataract or Lens Procedures, with CC Score 0–1 (1,393£), Very Major, Cataract or Lens Procedures, with CC Score 0–1 (903£), Intermediate, Cataract or Lens Procedures, with CC Score 0–1 (720£)(9) | 2021 | Tariffs are calculated from the reference cost; therefore, they include direct costs, variable overheads and fixed overheads (except teaching cost and research cost). They are used for reimbursement. | The tariffs are calculated as the combination of day case and ordinary elective spell. National tariffs for 2020/21 are modelled with costs taken from 2017/18 reference costs and activity data taken from 2017/18 Hospital Episode Statistics (HES) and 2017/18 reference costs. |
France | DRG | Tariff | Interventions on the lens with or without vitrectomy (1,355.87€) (10) | 2021 | Agence Technique de l’Information sur l’Hospitalization (ATIH). | Tariffs are based on DRG from the Social Health Insurance payer’s point of view. These are not reimbursement prices; one part of the cost is covered by patient or by an additional insurance. |
DRG | Cost | Interventions on the lens with or without vitrectomy (1,668€)(6) | 2017 | ScanSanté (ATIH database). Resources included in the final unit cost: [clinical activities (caregivers, medical and clinical staff), medico-technical activities (operating room, anaesthesia)], fixed overheads (119€) [(logistics and general management (general administrative services, hotel services, management information system, maintenance, restoration)) and variable overheads. Fixed overheads excludes research costs, teaching costs and financial costs. | Top-down micro-costing. These costs are based on costs provided by a sample of public and private hospitals on an annual basis. |
Germany | DRG | Cost | Bilateral extracapsular extraction of the lens with congenital malformation of the lens (2,263€); Bilateral extracapsular extraction of the lens without congenital malformation of the lens (1,634€) | 2020 | Institut für das Entgeltsystem im Krankenhaus; InEK(11). The cost includes all direct costs, variable overheads (except nursing) and fixed overheads (except teaching cost, research cost, depreciation of building and financial cost). | Top-down micro-costing. Inpatient cataract surgery. The unit cost is the result of multiplying a corresponding weight by ‘base cost’. |
Italy | DRG | Tariff | 994€(12) | 2012 | Tariffs are published by the Italian Ministry of Health and are calculated from costs. The tariff includes all direct costs, variable overheads and fixed overheads (except teaching cost, research cost and financial cost). | Top-down micro-costing. This tariff refers to the cataract surgery with or without vitrectomy. |
Poland | DRG | Tariff | Severity 1 (432.45€), severity 2 (504.99€)(13) | 2018 | Tariffs are published by the National Health Fund and are calculated from costs. They includes all direct costs, variable overheads and fixed overheads (except teaching cost, research cost and financial cost). | Top-down gross-costing. This tariff refers to day-case surgery. |
Portugal | DRG | Tariff | Severity 1 (1,313.65€), severity 2 (1,771.19€) and severity 3 (3,411.96€)(14) | 2018 | Tariffs are published by National Health Service and are calculated from costs. They do not vary between inpatient and day case surgery and includes all direct costs, variable overheads and fixed overheads. | Top-down micro-costing. DRGs make use of production costs taken from the Portuguese hospital cost database –which considers annual public hospitals cost information − and of Maryland weights. |
Slovenia | | Cost | 593.55€(15) | 2019 | Health Insurance Institute of Slovenia. The final unit cost includes personnel costs (1.1 specialist, who, in turn, includes 0.1 anaesthesiologist, 1 nurse, 1 health care technician and 0.47 administrative technical worker), variable overheads, premium for additional pension insurance, material, depreciation and additional funding for computerization. Two outpatient examinations (one before and the other after surgery) are also included. The cost excludes depreciation of building and financial cost. | Top-down gross-costing. The cost refers to outpatient surgery. |
Spain | DRG | Cost | 951€(16) | 2017 | Costs are published by the Spanish National Health System. They include all direct cost, variable overheads and fixed overheads (except teaching cost, research cost, depreciation of building and financial cost). Additionally, each Autonomous Region has its own list of tariffs or public prices(17–20). | Top-down micro/gross costing (depends on hospital). The costs refer to day case without specifying the type of surgery. |
Sweden | DRG | Tariff | Unilateral lens surgery (6,674 kr, regions: Blekinge, Halland and Kronoberg; 7,281 kr, region Skåne; 7,321 kr, regions: Jönköpings län, Kalmar län y Östergötland) and Bilateral lens surgery (13,777 kr, regions: Blekinge, Halland and Kronoberg; 15,029 kr, region Skåne; 15,059 kr, regions: Jönköpings län, Kalmar län y Östergötland)(21,22) | 2020 | Tariffs are published by corresponding healthcare regions. They include all direct cost, variable overhead and fixed overhead (except research cost and teaching cost). | In case the patients are treated in the University Hospital of Skåne, but they do not belong to the Southern Healthcare Region, a surcharge of 3.85% is charged. In case they are treated in Blekinge, Halland and Kronoberg, a surcharge of 2.85% is applied in case they do not belong to the Southern Healthcare Region. |