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Inpatient costs of major cardiovascular events
P W Radensky1, E Berliner, J W Archer
1Health Law Department, McDermott, Will & Emery, Miami, Florida, USA. pradensky@mwe.com
Insights
This study created a standardized library of inpatient hospital costs for cardiovascular events to improve comparisons in clinical trials. This cost library uses publicly available data for consistent economic analyses.
Area of Science:
- Health Economics
- Cardiovascular Medicine
- Health Services Research
Background:
- Economic evaluations in cardiovascular disease trials lack standardized cost data.
- Variations in cost assignment methods hinder cross-trial comparisons.
- A uniform approach to hospital cost estimation is needed for cardiovascular therapies.
Purpose of the Study:
- To develop a standard library of inpatient hospital costs for major cardiovascular events.
- To facilitate consistent economic analyses in clinical trials for new cardiovascular therapies.
Main Methods:
- Calculated mean and median hospital charges from Medicare admissions (HCUP NIS database).
- Converted charges to costs using Medicare cost-to-charge ratios.
- Updated costs to 1999 values using MedPAC forecasts.
Main Results:
- Inpatient costs for medical events ranged from $3654 to $7833 (1999 USD).
- Costs for surgical procedures ranged from $7054 to $46,317 (1999 USD).
- Hospital costs were higher for patients who died compared to those discharged.
Conclusions:
- A uniform method for estimating hospital costs was established using accessible data.
- The developed cost library can be updated annually.
- Standardized cost estimates will enhance economic analyses in cardiovascular clinical trials.
Objective:
Many trials of new therapies for cardiovascular disease include economic measures to assess the impact of treatment on healthcare costs, however, it is difficult to compare results between trials due to variation in methods for assigning costs. Therefore we developed a standard library of inpatient hospital costs for major cardiovascular events commonly reported in trials for new cardiovascular therapies.
Design:
Mean and median hospital charges for each event were calculated from Medicare admissions selected by ICD-9-CM codes from the most recent Healthcare Cost and Utilisation Project (HCUP) Nationwide Inpatient Sample (NIS) database available. Charges were converted to costs using the cost-to-charge ratio from the most recent Medicare cost report data and updated to 1999 using a model derived from the Medicare Payment Advisory Commission (MedPAC) forecast to recommend annual updates to Medicare.
Results:
Total hospital costs for medical events ranged from $US3654 (1999 values) to $US7833; total hospital costs for surgery and procedures ranged from $US7054 to $US46 317. The distribution of hospital costs is skewed with median costs and lengths of stay lower than mean values. Costs for patients who died in the hospital were generally higher than costs for patients who were discharged.
Conclusions:
The library of costs was calculated using a uniform method based on publicly available and easily accessible data and may be updated from year to year. This method provides standardised estimates of hospital costs that can be used in economic analyses of cardiovascular clinical trials.
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