Analysis of variable billing for nursing services based on patient classification

Health care cost containment and nursing's role in fiscal accountability are important areas of research in nursing administration. The use of patient classification as a means of variable billing for Nursing Services addresses the issue of care versus cost. The purposes of this study were to a) develop variable nursing care charger for the ICU/CCU at St. Mark's Hospital based of patient classification data from July 1, 1981 through June 30, 1982; b) compare and contrast projected revenues generated by per diem charges; c) compare and contrast projected and actual revenues with total costs and nursing costs, and d) formulate specific recommendations for the implementation of variable charging system to evaluate the fiscal efficiency of nursing services. The data were gathered from ICU/CCU Patient Classification Report Forms and Cost Analysis Reports to develop the Variable Nursing Charge System to be profitable in all four fiscal quarters with a closer proportional approximation of cost to revenues. The following implications for nursing administration are apparent. Patient classification is an efficient, effective means of manpower resource management. Variable billing based on patient classification can be developed to make nursing service an accountable revenue-generating department. Recommendations for implementation and suggestions for future research are also presented.