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Operative outcome and hospital cost
V A Ferraris1, S P Ferraris, A Singh
1Department of Cardiovascular Service, Marshall University, Huntington, WV, USA.
The Journal of Thoracic and Cardiovascular Surgery
|April 16, 1998
Summary
Operative death significantly increases hospital costs, with factors like congestive heart failure and elevated creatinine being key predictors. Preoperative interventions targeting these patient risk factors can help reduce overall healthcare expenses.
Area of Science:
- Cardiovascular Surgery
- Health Economics
- Medical Informatics
Background:
- Rising healthcare expenditures necessitate identification of patient risk factors for increased hospital costs.
- Understanding cost drivers is crucial for evaluating the relationship between hospital expenses, mortality, and morbidity.
Purpose of the Study:
- To identify patient risk factors associated with elevated hospital costs in cardiac procedures.
- To assess the correlation between increased hospital costs and in-hospital mortality and serious morbidity.
Main Methods:
- Screened over 100 patient variables in 1221 patients undergoing cardiac procedures.
- Calculated hospital costs using the cost-to-charge ratio.
- Employed univariate and multivariate statistics to analyze cost-outcome relationships.
Main Results:
- Operative death incurred the highest costs ($74,466), followed by serious nonfatal morbidity ($60,335) and uncomplicated survival ($31,459).
- Key independent predictors of increased hospital cost included preoperative congestive heart failure, elevated serum creatinine, and predicted mortality risk.
- Anesthesia and operating room expenses were major cost contributors in high-cost cases.
Conclusions:
- Operative death is the most costly outcome, and length of stay is an unreliable cost indicator.
- Patient risk factors for increased hospital cost differ from those for mortality or prolonged length of stay.
- Preoperative interventions for factors like anemia and congestive heart failure can mitigate costs; high-risk patient profiles can guide cost-reduction strategies.