Proposal for relative units of value (RUV) for use in allergy examinations.

Health resources are limited and consequently real cost generators must be identified to optimize resources. In the present article, we describe the structure of the Homogeneous Functional Groups (HFG) for Diagnostic Techniques in the Allergy Department of the Virgen de la Arrixaca University Hospital in Murcia (Spain) and the healthcare products generated. Based on the 2005 budget, variable costing was used to calculate the costs of the healthcare products generated (skin tests, investigation of drug allergies, etc.) by one of the three HFG (the HFG for complementary investigations). On the basis of these costs, and taking as the unit the cost of one skin prick test, we assigned relative units of value (RUV) to each of the products in our services portfolio. The following conclusions can be drawn: 1) the current system of variable costing provides information, which should be useful to health professionals; 2) the real cost generators in the microcosm of daily clinical practice should be identified to allow resource reallocation; 3) the costing system used enables modifications to be made that allow decision making on optimal use of the budget; 4) to take the decisions required to optimize resources, clinical management and complementary tests should go hand-in-hand.

Histamine release following the administration of iodinated contrast media during cardiac catheterization.

This study was motivated by the discrepancy in the results of published studies on the amount of histamine released following the intravascular administration of iodinated contrast media (ICM) in humans. From a group of patients due to undergo cardiac catheterization, we selected 45 subjects with no history of atopy. A central blood sample (left ventricle) was taken from each subject before and at various times following the administration of the ICM. We determined total and basal histamine levels in every sample. We did not find any significant difference in the total histamine concentration between the samples taken before and after the administration of the ICM; but the basal histamine concentration rose from 5.32 ng/ml to 11.26 ng/ml (p less than 10(-9)). This increase was inversely proportional to the time that had elapsed between the administration of the ICM and the taking of the sample (p less than 0.01). We believe that the inconclusiveness of the results from studies on histamine release following the administration of ICM may be explained by the dilution and inactivation of histamine in the systemic circulation.

Proposal for relative units of value (RUV) for use in allergy examinations / Propuesta de unidades relativas de valor para uso en los exámenes alergológicos

Health resources are limited and consequently real cost generators must be identified to optimize resources. In the present article, we describe the structure of the Homogeneous Functional Groups (HFG) for Diagnostic Techniques in the Allergy Department of the Virgen de la Arrixaca University Hospital in Murcia (Spain) and the healthcare products generated. Based on the 2005 budget, variable costing was used to calculate the costs of the healthcare products generated (skin tests, investigation of drug allergies, etc.) by one of the three HFG (the HFG for complementary investigations). On the basis of these costs, and taking as the unit the cost of one skin prick test, we assigned relative units of value (RUV) to each of the products in our services portfolio. The following conclusions can be drawn: 1) the current system of variable costing provides information, which should be useful to health professionals; 2) the real cost generators in the microcosm of daily clinical practice should be identified to allow resource reallocation; 3) the costing system used enables modifications to be made that allow decision making on optimal use of the budget; 4) to take the decisions required to optimize resources, clinical management and complementary tests should go hand-in-hand

Los recursos sanitarios son limitados, por lo que es preciso identificar los auténticos generadores del gasto, con el fin de poder optimizar los recursos. En la presente publicación se describe la estructura de los Grupos Funcionales Homogéneos (GFH) de Técnicas Diagnósticas del Servicio de Alergología del Hospital Universitario “Virgen de la Arrixaca” de Murcia (España), y los productos sanitarios que genera. Partiendo del presupuesto ejecutado durante el año 2005, y utilizando la contabilidad analítica, se calculan los costes de los productos sanitarios generados (pruebas cutáneas, estudios de alergia a medicamentos, etc.), producidos por uno de los GFH de los tres que la componen, a saber, el GFH de Exploraciones Complementarias. A partir de estos costes, tomando como unidad el coste del prick-test, asignamos unidades relativas de valor (URV), a cada uno de los productos de nuestra Cartera de Servicios. Como conclusiones cabe destacar que el actual sistema de gestión analítica: 1) Proporciona información y ésta debe de tener validez para el clínico. 2) Es necesario identificar verdaderos generadores de gastos en el microcosmos de la clínica diaria que permitan la reasignación de recursos. 3) Hace posible correcciones que permitan tomar decisiones para ejecutar de forma óptima el presupuesto. 4) La gestión clínica y la analítica deben de caminar al unísono, con el fin de poder tomar las medidas necesarias tendentes a optimizar los recursos