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Table 2 List of Cost Objects for EDs

From: Cost objects: How is your ED performing?

Services

Description

1

Administration of drugs by subcutaneous or intravenous injection

Administration of injectable medications of medications that can be administered to the patient without an additional approval process or paperwork because they are not controlled drugs.

2

Administration of non-injectable drugs

Administration either oral, buccal or other enteral route for non-injectable medications

of medications that can be administered to the patient without an additional approval process or paperwork because they are not controlled drugs.

3

Administration of non-injectable prescribed drugs

Administration either oral, buccal or other enteral route for prescribed non-injectable medication of medications that cannot be administered to the patient without an additional approval process or paperwork because they are controlled drugs.

4

Administration of prescribed drugs by subcutaneous or intravenous injection

Administration of injectable medications of medications that cannot be administered to the patient without an additional approval process or paperwork because they are controlled drugs.

5

Alcohol screening test

Application of validated screening tools for alcohol misuse and alcohol use disorder.

6

Application of a larger orthopedic medical cast

Procedure in which a large orthopedic cast is used to treat a trauma condition.

7

Application of a shorter orthopedic medical cast

Procedure in which a short orthopedic cast is used to treat a trauma condition.

8

Arterial blood gas sample

Arterial blood gas (ABG) sampling to obtain information on a patient’s respiratory status (blood oxygen and carbon dioxide levels), as well as the patient’s acid-base balance.

9

Black braided silk suture

Procedure for approximation and/or litigation of soft tissue in which a black braided silk suture is used. This type of surgical suture is a non-absorbable multifilament composed of an organic protein.

10

Bladder instillation

Bladder instillation is a combination drug therapy to help painful bladder or cystitis type symptoms including frequency, urgency, burning pain or stinging sensations when passing urine. It works by reducing inflammation and discomfort within the bladder.

11

Blood culture sample

Blood culture collection to test for foreign invaders like bacteria, yeast, and other microorganisms in the blood.

12

Blood glucose test

Procedure to test the amount of glucose in blood.

13

Blood sampling

Blood specimen collection to obtain blood for laboratory testing.

14

Burn wound dressing

Procedure to dress a dermal burn to absorb fluid, avoid maceration and seal the wound from the outside environment to reduce pain and infection.

15

Catgut suture

Surgical suture procedure in which a catgut suture is used. This type of suture is naturally degraded by the body’s own proteolytic enzymes. It is used for surgical procedures such as general closure, ophthalmic and orthopedics.

16

Complex foreign body extraction

Complex localization, incision and removal of foreign bodies because of the location of the foreign body inside the patient’s body and the material or shape of the foreign body.

17

Complex wound dressing

Procedure to dress a complex wound that requires specialist wound care intervention. Complex wound dressing often is a result of the treatment of any number of other conditions, including cardiac, pulmonary, neuromuscular and renal diseases.

18

Diagnostic and therapeutic puncture

Medical diagnostic and therapeutic puncture for sample and treatment purposes.

19

Diagnostic puncture

Medical diagnostic puncture for sample purposes.

20

Discharge of deceased patients

It involves all the administrative processes the ED needs to follow to discharge deceased patients.

21

Electrocardiogram

Test provided at the ED to evaluate whether the patient’s heart is beating at a normal rate and strength.

Services

Description

22

Endotracheal intubation

Endotracheal intubation is a medical procedure in which a tube is placed into the trachea, usually through the mouth, to assist breathing.

23

Enema

Procedure used to stimulate stool evacuation.

24

Feeding tube insertion

Technique in which a nasogastric tube is inserted into the patient’s nose, reaching first the back of the throat and then pushed down the esophagus until it reaches the stomach.

25

Histoacryl

Procedure in which histoacryl is applied for closing skin wounds.

26

Intramuscular drugs administration

Technique used to deliver medications deep into the muscles through an injection of medications that can be administered to the patient without an additional approval process or paperwork because they are not controlled drugs.

27

Intramuscular prescribed drugs administration

Technique used to deliver medications deep into the muscles through an injection of medications that cannot be administered to the patient without an additional approval process or paperwork because they are controlled drugs.

28

Installation of a removable cast walker boot

Procedure in which a removable cast walker boot is placed to treat trauma conditions such as severe sprains, fractures, and tendon or ligament tears in the ankle or foot.

29

IV fluid change

Procedure in which the IV fluid bag is change for another one based on the needs of the patient.

30

Life risk care management

It involves all the administrative processes the ED needs to follow to admit a patient with a life-threatening condition regardless of their ability to pay.

31

Management of imaging tests

It involves all the administrative processes the ED needs to follow to ensure that an ED patient is scheduled (if an appointment is required) for the imaging tests prescribed and transported from the ED to the Imaging Unit and back to the ED.

32

Medical attention of patients arrived by ambulance

It involves all the administrative processes the ED needs to follow to admit a patient arriving by ambulance.

33

Medical consultation

It includes the administrative process required to admit the patient into the ED, as well as the physician’s evaluation.

34

Medical interconsultation

It includes the administrative process required to ask a specialist to further evaluate the patient, in order to correctly diagnose the patient, as well as the specialist’s evaluation.

35

Medium-complex foreign body extraction

Medium-complex localization, incision and removal of foreign bodies because of the location of the foreign body inside the patient’s body or the material or shape of the foreign body.

36

Monofilament nylon suture

Procedure for approximation and/or litigation of tissue in which a monofilament nylon suture is used. This type of suture is non-absorbable by the body.

37

Nebulization

Procedure in which a nebulizer is used to treat a person with asthma or another respiratory condition to administer medication directly and quickly to the lungs.

38

Observation day

It involves all the procedures required to monitor the patient’s status while the patient remains under observation.

39

Orthopedic trauma medical attention

It includes the administrative process required to admit the patient into the ED, as well as the evaluation of the patient’s condition by an orthopedic trauma specialist.

40

Oxygen therapy

Procedure in which oxygen is provided if oxygen saturation on a patient is below the threshold defined as desirable for the patient’s condition in order to reach the targeted oxygen saturation level.

41

Phleboclysis

It corresponds to the administration of fluids intravenously drop by drop, by the drip method, through a peripheral catheter.

42

Polypropylene suture

Procedure for approximation and/or litigation of tissue in which a polypropylene suture is used. This type of suture is non-absorbable by the body.

43

Preparation of patients for hospitalization

It includes the administrative process, preparation and transference of patients to be hospitalized.

44

Preparation of patients for surgery

It includes the administrative process, preparation and transference of patients for surgery.

45

Reduction

Procedure to repair a fracture or dislocation to the correct alignment without surgery.

46

Referral

It includes all the administrative processes required to transfer a patient to another hospital, primarily because the hospital currently treating the patient has not all the resources required to successfully treat the patient’s condition.

47

Resuscitation

A life-saving procedure performed when someone has stopped breathing or the heart has stopped beating, as in cardiopulmonary resuscitation (CPR).

48

Secretion clearance

Technique aiming to remove sputum (the combination of mucus and saliva) from the patient’s lungs.

49

Simple foreign body extraction

Simple localization, incision and removal of foreign bodies because the foreign body is located in a place of the body easy to reach and the material or shape of the foreign body are not likely to cause harm while the extraction process is conducted.

50

Simple wound dressing

Procedure to dress a simple wound. This type of wound is defined as a dry dressing, apply to viable skin which does not require specialist wound care intervention.

51

Skin suture

Procedure for approximation and/or litigation of tissue using cutaneous suture.

52

Splinting

Procedure to apply a rigid or flexible device that maintains in position a displaced or movable part; also used to keep in place and protect an injured part.

53

Stomach pumping

Procedure of cleaning out the contents of the stomach through a gastric lavage.

54

Stool sample

Stool specimen collection to obtain stool (feces) for laboratory testing.

55

Teaching activities

It includes all the teaching and research activities carried out within the ED.

56

Urethral sounding

Procedure that involves inserting a sound into the urethra for dilatation of strictures or for obtaining access to the bladder.

57

Urine specimen collection

Urine specimen collection to obtain urine for laboratory testing.

58

Verify injuries

Procedures requested by a judicial order or the police to verify type and severity of injuries.

59

Vicryl suture

Procedure for approximation and/or litigation of tissue using vicryl suture. This type of suture is absorbable, synthetic, and normally braided.