A new methodology for ancillary services review

This study used life table analysis techniques to evaluate the daily charges generated for diagnostic tests, procedures, and therapies for a sample of patients without regard to diagnosis and for patients with a primary diagnosis of congestive heart failure. The study indicated that about 50% of all ancillary services ordered are accumulated by the 5th day of stay and 75% by the 9th day. Length-of-stay review (LOS) undertaken after the 9th day, therefore, affects only 25% of tests and treatments. A method is proposed to generate data useful for reviewing the diagnostic tests, procedures, and therapies ordered during the early days of a patient's hospital stay. This approach has relevance for cost control under the new diagnosis-related groups reimbursement plan.