Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery
Procedure-related costs are of increasing concern in selecting the appropriate procedure for the treatment of coronary artery disease (CAD). To determine what preoperative factors influence total postoperative hospital costs, data on 604 coronary artery bypass graft surgery (CABG) patients from 1990...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1994-11, Vol.90 (5 Pt 2), p.II124-II128 |
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| container_issue | 5 Pt 2 |
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| container_title | Circulation (New York, N.Y.) |
| container_volume | 90 |
| creator | Smith, L R Milano, C A Molter, B S Elbeery, J R Sabiston, Jr, D C Smith, P K |
| description | Procedure-related costs are of increasing concern in selecting the appropriate procedure for the treatment of coronary artery disease (CAD).
To determine what preoperative factors influence total postoperative hospital costs, data on 604 coronary artery bypass graft surgery (CABG) patients from 1990 to 1991 were analyzed. Professional fees were excluded. Hospital costs were computed by multiplying patient charges by the Medicare cost-to-charge ratio used in determining federal reimbursement. Median postoperative cost was $12,912 (range $7100 to $259,546). Data were analyzed with a semiparametric regression model. Patients dying in the hospital were censored at time of death. There were significant differences among surgeons in costs but no significant differences in operative mortality. Significant risk factors for increased cost after adjusting for surgeon were: older age (P < .0001), lower left ventricular ejection fraction (P < .0001), prior CABG (P < .0001), female sex (P < .0049), no prior percutaneous transluminal coronary angioplasty (P < .0091), increased degree of CAD (P < .0102), black race (P < .0190), and diabetes (P < .032).
These results suggest that preoperative characteristics have important economic and medical implications. Surgeons should compare their management strategies on the basis of data analysis to determine the most effective practice with regard to mortality and cost. |
| format | Article |
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To determine what preoperative factors influence total postoperative hospital costs, data on 604 coronary artery bypass graft surgery (CABG) patients from 1990 to 1991 were analyzed. Professional fees were excluded. Hospital costs were computed by multiplying patient charges by the Medicare cost-to-charge ratio used in determining federal reimbursement. Median postoperative cost was $12,912 (range $7100 to $259,546). Data were analyzed with a semiparametric regression model. Patients dying in the hospital were censored at time of death. There were significant differences among surgeons in costs but no significant differences in operative mortality. Significant risk factors for increased cost after adjusting for surgeon were: older age (P < .0001), lower left ventricular ejection fraction (P < .0001), prior CABG (P < .0001), female sex (P < .0049), no prior percutaneous transluminal coronary angioplasty (P < .0091), increased degree of CAD (P < .0102), black race (P < .0190), and diabetes (P < .032).
These results suggest that preoperative characteristics have important economic and medical implications. Surgeons should compare their management strategies on the basis of data analysis to determine the most effective practice with regard to mortality and cost.]]></description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>PMID: 7955238</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Adult ; Age Factors ; Aged ; Coronary Artery Bypass - economics ; Coronary Disease - epidemiology ; Coronary Disease - surgery ; Cost-Benefit Analysis ; Diabetes Mellitus - epidemiology ; Female ; Hospital Costs - statistics & numerical data ; Hospital Mortality ; Hospitals, University - economics ; Humans ; Logistic Models ; Male ; Middle Aged ; North Carolina ; Postoperative Care - economics ; Risk Factors ; Sex Factors ; Stroke Volume</subject><ispartof>Circulation (New York, N.Y.), 1994-11, Vol.90 (5 Pt 2), p.II124-II128</ispartof><rights>Copyright American Heart Association, Inc. Nov 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7955238$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smith, L R</creatorcontrib><creatorcontrib>Milano, C A</creatorcontrib><creatorcontrib>Molter, B S</creatorcontrib><creatorcontrib>Elbeery, J R</creatorcontrib><creatorcontrib>Sabiston, Jr, D C</creatorcontrib><creatorcontrib>Smith, P K</creatorcontrib><title>Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description><![CDATA[Procedure-related costs are of increasing concern in selecting the appropriate procedure for the treatment of coronary artery disease (CAD).
To determine what preoperative factors influence total postoperative hospital costs, data on 604 coronary artery bypass graft surgery (CABG) patients from 1990 to 1991 were analyzed. Professional fees were excluded. Hospital costs were computed by multiplying patient charges by the Medicare cost-to-charge ratio used in determining federal reimbursement. Median postoperative cost was $12,912 (range $7100 to $259,546). Data were analyzed with a semiparametric regression model. Patients dying in the hospital were censored at time of death. There were significant differences among surgeons in costs but no significant differences in operative mortality. Significant risk factors for increased cost after adjusting for surgeon were: older age (P < .0001), lower left ventricular ejection fraction (P < .0001), prior CABG (P < .0001), female sex (P < .0049), no prior percutaneous transluminal coronary angioplasty (P < .0091), increased degree of CAD (P < .0102), black race (P < .0190), and diabetes (P < .032).
These results suggest that preoperative characteristics have important economic and medical implications. Surgeons should compare their management strategies on the basis of data analysis to determine the most effective practice with regard to mortality and cost.]]></description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Coronary Artery Bypass - economics</subject><subject>Coronary Disease - epidemiology</subject><subject>Coronary Disease - surgery</subject><subject>Cost-Benefit Analysis</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>Hospital Costs - statistics & numerical data</subject><subject>Hospital Mortality</subject><subject>Hospitals, University - economics</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>North Carolina</subject><subject>Postoperative Care - economics</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Stroke Volume</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkFtLxDAQhYMo67r6E4Tgg2-FNpNL-yiLN1jQB30uk0vXLtumJqmy_96AC4JPwznzzXBmTsiyEowXXEBzSpZlWTaFAsbOyUWMuywlKLEgC9UIwaBeEvcanJ9cwNR_OWpdcmHoRxxTpL6jk4_pr2uyihRj9KbH5Cz97tNHdoMfMRwohjx8oPowZYRuA3aJxjlss3lJzjrcR3d1rCvy_nD_tn4qNi-Pz-u7TTExgFTwWhqtQAOCMeg6I0vFFVaVNUqWDcvKGG1Ac844WGkcoEWBtWbCMlPDitz-7p2C_5xdTO3QR-P2exydn2OrZF1VdQkZvPkH7vwcxpytZRWTgjHVZOj6CM16cLadQj_kQ9vj8-AHh9luxg</recordid><startdate>199411</startdate><enddate>199411</enddate><creator>Smith, L R</creator><creator>Milano, C A</creator><creator>Molter, B S</creator><creator>Elbeery, J R</creator><creator>Sabiston, Jr, D C</creator><creator>Smith, P K</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>199411</creationdate><title>Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery</title><author>Smith, L R ; Milano, C A ; Molter, B S ; Elbeery, J R ; Sabiston, Jr, D C ; Smith, P K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p233t-486cb73b3a3ccaefc60747a11dc76092074ccbc3b44243d6ce3ada5a8b25d2c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Coronary Artery Bypass - economics</topic><topic>Coronary Disease - epidemiology</topic><topic>Coronary Disease - surgery</topic><topic>Cost-Benefit Analysis</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>Hospital Costs - statistics & numerical data</topic><topic>Hospital Mortality</topic><topic>Hospitals, University - economics</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>North Carolina</topic><topic>Postoperative Care - economics</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Stroke Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smith, L R</creatorcontrib><creatorcontrib>Milano, C A</creatorcontrib><creatorcontrib>Molter, B S</creatorcontrib><creatorcontrib>Elbeery, J R</creatorcontrib><creatorcontrib>Sabiston, Jr, D C</creatorcontrib><creatorcontrib>Smith, P K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smith, L R</au><au>Milano, C A</au><au>Molter, B S</au><au>Elbeery, J R</au><au>Sabiston, Jr, D C</au><au>Smith, P K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1994-11</date><risdate>1994</risdate><volume>90</volume><issue>5 Pt 2</issue><spage>II124</spage><epage>II128</epage><pages>II124-II128</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract><![CDATA[Procedure-related costs are of increasing concern in selecting the appropriate procedure for the treatment of coronary artery disease (CAD).
To determine what preoperative factors influence total postoperative hospital costs, data on 604 coronary artery bypass graft surgery (CABG) patients from 1990 to 1991 were analyzed. Professional fees were excluded. Hospital costs were computed by multiplying patient charges by the Medicare cost-to-charge ratio used in determining federal reimbursement. Median postoperative cost was $12,912 (range $7100 to $259,546). Data were analyzed with a semiparametric regression model. Patients dying in the hospital were censored at time of death. There were significant differences among surgeons in costs but no significant differences in operative mortality. Significant risk factors for increased cost after adjusting for surgeon were: older age (P < .0001), lower left ventricular ejection fraction (P < .0001), prior CABG (P < .0001), female sex (P < .0049), no prior percutaneous transluminal coronary angioplasty (P < .0091), increased degree of CAD (P < .0102), black race (P < .0190), and diabetes (P < .032).
These results suggest that preoperative characteristics have important economic and medical implications. Surgeons should compare their management strategies on the basis of data analysis to determine the most effective practice with regard to mortality and cost.]]></abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>7955238</pmid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0009-7322 |
| ispartof | Circulation (New York, N.Y.), 1994-11, Vol.90 (5 Pt 2), p.II124-II128 |
| issn | 0009-7322 1524-4539 |
| language | eng |
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| source | MEDLINE; American Heart Association; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Age Factors Aged Coronary Artery Bypass - economics Coronary Disease - epidemiology Coronary Disease - surgery Cost-Benefit Analysis Diabetes Mellitus - epidemiology Female Hospital Costs - statistics & numerical data Hospital Mortality Hospitals, University - economics Humans Logistic Models Male Middle Aged North Carolina Postoperative Care - economics Risk Factors Sex Factors Stroke Volume |
| title | Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery |
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