How much do hospital staff know, how much do they care, and what should they know about economic aspects of Diagnosis Related Groups? The case of an Italian children’s hospital

Background: Diagnosis Related Group (DRG) costing enables more efficient therapeutic choices. For this to occur, staff must be aware of the costs of the resources used in the process. Objective: The paper aims to identify potential information gaps of physicians, nurses, and administrative staff regarding economic aspects. It explores the intersection of financial awareness and the perceived importance of economic factors to evaluate the information deficiencies across these professional groups. Methods: The costs of DRG 546 different phases are estimated. Data on economic factors awareness (EFA) and economic factors importance (EFI) are gathered through a questionnaire. The survey involved 61 Italian employees of an Italian children’s hospital among physicians, nurses, and administrative staff. Results: A trade-off emerges between the scarce knowledge of the DRG economic aspects and their importance for physicians and nurses. Awareness of economic aspects does not depend on years of seniority. Conclusions: Economic factors awareness is low, although the staff considers this issue important. An information gap needs to be addressed. Clinical staff are partially aware of the costs of the activities in which they are directly involved, but they are unaware of other economic aspects of the therapeutic process. Nurses are the professional group with the lowest cost awareness. Different professional groups require different financial information. Physicians and nurses should be aware of relevant costs and the cost of activities with negligible impact on patient outcomes. Potential implications: Administrative offices often do not know what economic data could be helpful in the physicians’ or nurses’ decisions. In addition, medical and nursing staff do not know precisely what information to ask for. Workgroups composed of administrative and healthcare staff should define what relevant financial data should be provided and how.