Development of a charge adjustment model for cardiac catheterization

Area of Science:

• Cardiology
• Health Economics
• Medical Informatics

Background:

• Lack of standardized methodology for comparing catheterization costs in congenital heart disease.
• Existing financial metrics do not correlate well with procedure complexity.

Purpose of the Study:

• Develop and validate a financial grouper for catheterization procedures in congenital heart disease.
• Enable standardized cost comparisons across institutions.

Main Methods:

• Linked catheterization database with hospital charges (FY 2008-2010).
• Developed Catheterization Charge Categories (CCC) using empiric data and expert consensus.
• Created a multivariable model including CCC, patient, and procedural characteristics.

Main Results:

• Categorized 40 procedure types into 7 CCC, explaining 72.6% of charge variation.
• Largest categories: CCC 2 (diagnostic, 34%) and CCC 1 (biopsy, 12%).
• Final model (CCC, interventions, diagnosis) explained 74.2% of charge variation.

Conclusions:

• Developed a novel financial grouper (CCC) for congenital heart disease catheterization.
• CCC and the multivariable model facilitate understanding and comparison of financial data.
• This tool accounts for diverse patient populations and procedure types.