Hospitals with decreasing cost-to-charge ratios bill greater surgical charges for similar outcomes
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View abstract on PubMed
Summary
This summary is machine-generated.Hospitals with decreasing cost-to-charge ratios charge significantly more for services, despite minimal increases in costs and no impact on patient outcomes. Charges, not clinical factors, drive these trends.
Area Of Science
- Health Services Research
- Hospital Administration
- Healthcare Economics
Background
- The cost-to-charge ratio (CCR) reflects hospital service markups, where a lower CCR indicates lower costs or higher charges.
- Understanding CCR trends is crucial for assessing hospital financial practices and their impact on patient care.
Purpose Of The Study
- To investigate factors associated with cost-to-charge ratio trends in hospitals.
- To determine if a decreasing cost-to-charge ratio is linked to adverse surgical outcomes.
Main Methods
- Utilized the Florida Agency for Healthcare Administration Inpatient database (2018-2020) for common surgical procedures.
- Integrated data from Distressed Communities Index, RAND Corporation, CMS Cost Reports, and AHA.
- Employed interpretable machine learning to predict CCR trends and identify influential factors in hospitals with monotonic CCR changes.
Main Results
- Included 67 hospitals (40 decreasing CCR, 27 increasing CCR) with 35,661 surgeries.
- Decreasing CCR hospitals were more often proprietary, had higher mean total charges, and marginally higher estimated costs.
- No significant differences in mortality or overall complications were observed between decreasing and increasing CCR hospitals, despite higher comorbidity rates in decreasing CCR hospitals.
Conclusions
- Hospitals with decreasing cost-to-charge ratios exhibit substantially higher charges with only minor cost increases and no difference in patient outcomes.
- Hospital charges, rather than patient clinical factors or case-mix, were the primary drivers of cost-to-charge ratio trends.
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