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Costsandfinancesinhospitals
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ity”correspondstowhatismeasuredwiththeEuroqolquestionnaire.Directreading
oftheresultsprovidedbythepatientsonthevisualanalogicscalewastermed"per-
ceivedqualityoflife”.
3)Hospitalizationtime:Theaveragelengthofstay(ALS)inhospitalwasassessed
foreachpatientandcomparedwiththenationalcostscaleaccordingtothelevelof
socialdisabilityforeachpatient.Thedatawereobtainedfromtheanonymizeddata
oftheGHS[Table1].
4)Extrahospitaldays:Thenumberofextradaysduetosocialdisabilitywasesti-
matedforthewholehospitalfromthequalityoflifeanddifferencesbetweentheALS
observedandthenationalcostscale.Thequalityofliferesultingfromeachclassof
socialdisabilitywascomparedtoestimatetheadditionalresources(RS)required:RS
=Q1/Qi(withQ1,theaveragequalityoflifeobservedinclass1[nosocialdisabil-
ity]andQi,theaveragequalityoflifeobservedintheotherclassesi,i1).Theextra
resourcesrequired(ERS)canbecalculatedastheaverageweightedbythefrequency
observedforeachsocialdisability.Wethusobtain:
j
ERS=RSi
ni
n
fortheiclassesofsocialdisability
i=1
(i=1toj,withjthelastclasscomputedandnrepresentssamplesizeandn
i,sample
sizeforclassi).
Estimationofdifferentialhospitalcostaccordingtothelengthofstay:Thelength
ofstayobservedforeachclassofdisabilityperGHSforeachpatientmakesitpos-
sibletoextrapolatethenumberofextradaysneededforthecareofsocialdisabilityto
thewholehospital.Itisinterestingtocomparethisresultwiththatobtainedfromthe
qualityoflifemethod.Byanalogywiththepreviousmethod,wehave:RS=ALS1
/ALSi(withALS1:thedifferentialaveragelengthofstayobservedinclass1com-
paredwiththeENC[EchelleNationaledeCoût,nationalcostscale];ALSi:thedif-
ferentialaverageobservedinclassicomparedwiththeENC).ENChasbeentakenas
acomparatorbecauseitisthegoldstandardforlengthofstay(theoreticalreference).
ThecostassociatedwitheachGHMwasevaluatedbythenationaldatabasedon40
participatinghospitals.Thus,thenationalscaleisareferenceintermsoflengthof
staybutnotintermsofcost.UsingtheENCwillguaranteethatanydeviationisnot
duetoadifferenceinthehospitalizedGHMofanysocialclass.Atheoreticaldistribu-
tionofstaysaccordingtodisabilityclasscanbeobtainedbyapplyingthedistribution
ofdisabledpatientstothetotalnumberofstays.Anumberofextradayscorresponds
toeachdisabilityclass,exceptforpatientsinthereferenceclass1.Foreachdisability
class,thenumberofextradaysobservedisthenmultipliedbythenumberoftheoreti-
calstaystoobtainthenumberofadditionaldaysresultingfromsocialdisability.The
averagedifferentialobservedcanbecomparedwiththeENCforeachpatientandfor
eachclassofdisability.