The changing costs of hospital treatment for colic: a preliminary audit

Reasons for performing study:

Treatment of colic can be expensive and may exceed the owners’ financial limitations. This may result in premature euthanasia prior to treatment on rectifiable financial grounds rather than for welfare reasons. It is therefore important to ensure appropriate business model auditing to identify where costs may limit expected treatment options.

Objectives:

This study investigated how the costs of treatment for equine colic at a single university referral hospital have changed over a 10-year period between 2003 and 2013. The aim was to analyse which costs have changed excessively or disproportionately between different treating services, consumables and professional fees, which may render treatment of colic financially prohibitive.

Study design:

Retrospective study. Methods: All charges billed against cases undergoing treatment for colic between 2003 and 2013 were accessed from hospital records. Horses were identified as having surgery or purely medical management. Charges were categorised by service (medicine, surgery, anaesthesia), type (consumable, livery, professional fee), and consumable type (e.g. NSAID, opiate, antibiotic, fluid therapy, lab fee, surgery consumables).

Results:

There was a significant association between year and the frequency of medically and surgically treated colic (Chi-square test, P<0.001). Between 2003 and 2012, median total treatment costs increased in both medically (42%) and surgically treated (46%) cases. Costs attributable to consumables increased (surgical cases 28%, medical cases 14%), while those attributable to livery (surgical -19%, medical -21%) and professional fees decreased (surgical -22%, medical -8%). The greatest increase in consumable cost was attributable to fluids (surgical 94%, medical 182%).

Conclusions:

This study demonstrates areas where the cost of colic treatment are disproportionately changing and thus highlights potential targets where business models may be optimised in the interest of patient survival. The substantial increase in costs attributable to fluids correlates with increasing emphasis on fluid therapy in the management of colic.