Identification of risk factors for increased cost, charges, and length of stay for cardiac patients
Background. In this study we explored different risk model options to provide clinicians with predictions for resource utilization. The hypotheses were that predictors of mortality are not predictive of resource consumption, and that there is a correlation between cost estimates derived using a cost...
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Veröffentlicht in: | The Annals of thoracic surgery 2000-09, Vol.70 (3), p.702-710 |
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container_title | The Annals of thoracic surgery |
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creator | MaWhinney, Samantha Brown, Elizabeth R Malcolm, Janet VillaNueva, Catherine Groves, Bertron M Quaife, Robert A Lindenfeld, JoAnn Warner, Bradley A Hammermeister, Karl E Grover, Frederick L Shroyer, A.Laurie W |
description | Background. In this study we explored different risk model options to provide clinicians with predictions for resource utilization. The hypotheses were that predictors of mortality are not predictive of resource consumption, and that there is a correlation between cost estimates derived using a cost-to-charge ratio or a product-line costing approach.
Methods. From March 1992 to June 1995, 2,481 University of Colorado Hospital patients admitted for ischemic heart disease were classified by diagnosis-related group code as having undergone or experienced coronary bypass procedures (CBP), percutaneous cardiovascular procedures (PCVP), acute myocardial infarction (AMI), and other cardiac-related discharges (Other). For each diagnosis-related group, Cox proportional hazards models were developed to determine predictors of cost, charges, and length of stay.
Results. The diagnosis groups differed in the clinical factors that predicted resource use. As the two costing methods were highly correlated, either approach may be used to assess relative resource consumption provided costs are reconciled to audited financial statements.
Conclusions. To develop valid prediction models for costs of care, the clinical risk factors that are traditionally used to predict risk-adjusted mortality may need to be expanded. |
doi_str_mv | 10.1016/S0003-4975(00)01510-1 |
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Methods. From March 1992 to June 1995, 2,481 University of Colorado Hospital patients admitted for ischemic heart disease were classified by diagnosis-related group code as having undergone or experienced coronary bypass procedures (CBP), percutaneous cardiovascular procedures (PCVP), acute myocardial infarction (AMI), and other cardiac-related discharges (Other). For each diagnosis-related group, Cox proportional hazards models were developed to determine predictors of cost, charges, and length of stay.
Results. The diagnosis groups differed in the clinical factors that predicted resource use. As the two costing methods were highly correlated, either approach may be used to assess relative resource consumption provided costs are reconciled to audited financial statements.
Conclusions. To develop valid prediction models for costs of care, the clinical risk factors that are traditionally used to predict risk-adjusted mortality may need to be expanded.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(00)01510-1</identifier><identifier>PMID: 11016297</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiology. Vascular system ; Colorado ; Coronary heart disease ; Costs and Cost Analysis ; Diagnosis-Related Groups ; Fees and Charges ; Female ; Heart ; Humans ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Models, Theoretical ; Myocardial Ischemia - economics ; Myocardial Ischemia - mortality ; Myocardial Ischemia - therapy ; Risk Factors ; Severity of Illness Index</subject><ispartof>The Annals of thoracic surgery, 2000-09, Vol.70 (3), p.702-710</ispartof><rights>2000 The Society of Thoracic Surgeons</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-1735adb247c7312e69adeb76b643d23eef3c36e2368703888703c14f4e87fe063</citedby><cites>FETCH-LOGICAL-c425t-1735adb247c7312e69adeb76b643d23eef3c36e2368703888703c14f4e87fe063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-4975(00)01510-1$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1518109$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11016297$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MaWhinney, Samantha</creatorcontrib><creatorcontrib>Brown, Elizabeth R</creatorcontrib><creatorcontrib>Malcolm, Janet</creatorcontrib><creatorcontrib>VillaNueva, Catherine</creatorcontrib><creatorcontrib>Groves, Bertron M</creatorcontrib><creatorcontrib>Quaife, Robert A</creatorcontrib><creatorcontrib>Lindenfeld, JoAnn</creatorcontrib><creatorcontrib>Warner, Bradley A</creatorcontrib><creatorcontrib>Hammermeister, Karl E</creatorcontrib><creatorcontrib>Grover, Frederick L</creatorcontrib><creatorcontrib>Shroyer, A.Laurie W</creatorcontrib><title>Identification of risk factors for increased cost, charges, and length of stay for cardiac patients</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. In this study we explored different risk model options to provide clinicians with predictions for resource utilization. The hypotheses were that predictors of mortality are not predictive of resource consumption, and that there is a correlation between cost estimates derived using a cost-to-charge ratio or a product-line costing approach.
Methods. From March 1992 to June 1995, 2,481 University of Colorado Hospital patients admitted for ischemic heart disease were classified by diagnosis-related group code as having undergone or experienced coronary bypass procedures (CBP), percutaneous cardiovascular procedures (PCVP), acute myocardial infarction (AMI), and other cardiac-related discharges (Other). For each diagnosis-related group, Cox proportional hazards models were developed to determine predictors of cost, charges, and length of stay.
Results. The diagnosis groups differed in the clinical factors that predicted resource use. As the two costing methods were highly correlated, either approach may be used to assess relative resource consumption provided costs are reconciled to audited financial statements.
Conclusions. To develop valid prediction models for costs of care, the clinical risk factors that are traditionally used to predict risk-adjusted mortality may need to be expanded.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Colorado</subject><subject>Coronary heart disease</subject><subject>Costs and Cost Analysis</subject><subject>Diagnosis-Related Groups</subject><subject>Fees and Charges</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Theoretical</subject><subject>Myocardial Ischemia - economics</subject><subject>Myocardial Ischemia - mortality</subject><subject>Myocardial Ischemia - therapy</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF1rFDEUhoModq3-BCUXIgodzcckmbkSKX4UCr2oXofsyUkbnZ2sSbbQf29md7GXvckhnOd9Ex5CXnP2kTOuP10zxmTXj0a9Z-wD44qzjj8hK66U6LRQ41Oy-o-ckBel_G5X0dbPyQlfKsRoVgQuPM41hgiuxjTTFGiO5Q8NDmrKhYaUaZwhoyvoKaRSzyjcunyD5Yy62dMJ55t6u-RKdfd7Hlz20QHdtspWXl6SZ8FNBV8d5yn59e3rz_Mf3eXV94vzL5cd9ELVjhupnF-L3oCRXKAence10WvdSy8kYpAgNQqpB8PkMCwn8D70OJiATMtT8u7Qu83p7w5LtZtYAKfJzZh2xRohmdB7UB1AyKmUjMFuc9y4fG85s4sau7drF3WWMbu3a3nLvTk-sFtv0D-kjjob8PYIuAJuCtnNEMsDp_jA2diwzwcMm427iNkWaKYAfcwI1foUH_nJPy3OlaQ</recordid><startdate>20000901</startdate><enddate>20000901</enddate><creator>MaWhinney, Samantha</creator><creator>Brown, Elizabeth R</creator><creator>Malcolm, Janet</creator><creator>VillaNueva, Catherine</creator><creator>Groves, Bertron M</creator><creator>Quaife, Robert A</creator><creator>Lindenfeld, JoAnn</creator><creator>Warner, Bradley A</creator><creator>Hammermeister, Karl E</creator><creator>Grover, Frederick L</creator><creator>Shroyer, A.Laurie W</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000901</creationdate><title>Identification of risk factors for increased cost, charges, and length of stay for cardiac patients</title><author>MaWhinney, Samantha ; Brown, Elizabeth R ; Malcolm, Janet ; VillaNueva, Catherine ; Groves, Bertron M ; Quaife, Robert A ; Lindenfeld, JoAnn ; Warner, Bradley A ; Hammermeister, Karl E ; Grover, Frederick L ; Shroyer, A.Laurie W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-1735adb247c7312e69adeb76b643d23eef3c36e2368703888703c14f4e87fe063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Colorado</topic><topic>Coronary heart disease</topic><topic>Costs and Cost Analysis</topic><topic>Diagnosis-Related Groups</topic><topic>Fees and Charges</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Theoretical</topic><topic>Myocardial Ischemia - economics</topic><topic>Myocardial Ischemia - mortality</topic><topic>Myocardial Ischemia - therapy</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MaWhinney, Samantha</creatorcontrib><creatorcontrib>Brown, Elizabeth R</creatorcontrib><creatorcontrib>Malcolm, Janet</creatorcontrib><creatorcontrib>VillaNueva, Catherine</creatorcontrib><creatorcontrib>Groves, Bertron M</creatorcontrib><creatorcontrib>Quaife, Robert A</creatorcontrib><creatorcontrib>Lindenfeld, JoAnn</creatorcontrib><creatorcontrib>Warner, Bradley A</creatorcontrib><creatorcontrib>Hammermeister, Karl E</creatorcontrib><creatorcontrib>Grover, Frederick L</creatorcontrib><creatorcontrib>Shroyer, A.Laurie W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MaWhinney, Samantha</au><au>Brown, Elizabeth R</au><au>Malcolm, Janet</au><au>VillaNueva, Catherine</au><au>Groves, Bertron M</au><au>Quaife, Robert A</au><au>Lindenfeld, JoAnn</au><au>Warner, Bradley A</au><au>Hammermeister, Karl E</au><au>Grover, Frederick L</au><au>Shroyer, A.Laurie W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification of risk factors for increased cost, charges, and length of stay for cardiac patients</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2000-09-01</date><risdate>2000</risdate><volume>70</volume><issue>3</issue><spage>702</spage><epage>710</epage><pages>702-710</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. In this study we explored different risk model options to provide clinicians with predictions for resource utilization. The hypotheses were that predictors of mortality are not predictive of resource consumption, and that there is a correlation between cost estimates derived using a cost-to-charge ratio or a product-line costing approach.
Methods. From March 1992 to June 1995, 2,481 University of Colorado Hospital patients admitted for ischemic heart disease were classified by diagnosis-related group code as having undergone or experienced coronary bypass procedures (CBP), percutaneous cardiovascular procedures (PCVP), acute myocardial infarction (AMI), and other cardiac-related discharges (Other). For each diagnosis-related group, Cox proportional hazards models were developed to determine predictors of cost, charges, and length of stay.
Results. The diagnosis groups differed in the clinical factors that predicted resource use. As the two costing methods were highly correlated, either approach may be used to assess relative resource consumption provided costs are reconciled to audited financial statements.
Conclusions. To develop valid prediction models for costs of care, the clinical risk factors that are traditionally used to predict risk-adjusted mortality may need to be expanded.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11016297</pmid><doi>10.1016/S0003-4975(00)01510-1</doi><tpages>9</tpages></addata></record> |
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subjects | Aged Biological and medical sciences Cardiology. Vascular system Colorado Coronary heart disease Costs and Cost Analysis Diagnosis-Related Groups Fees and Charges Female Heart Humans Length of Stay Male Medical sciences Middle Aged Models, Theoretical Myocardial Ischemia - economics Myocardial Ischemia - mortality Myocardial Ischemia - therapy Risk Factors Severity of Illness Index |
title | Identification of risk factors for increased cost, charges, and length of stay for cardiac patients |
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