Determinants of hospital charges for coronary artery bypass surgery: the economic consequences of postoperative complications.
This is a prospective study of 500 consecutive patients having coronary artery bypass surgery; mean hospital charge from time of surgery to discharge was +11,900 +/- 12,700. Multiple regression analysis was performed using preoperative variables and postoperative complications. No preoperative clinical feature was a significant predictor of higher average charge. Sternal wound infection (p = 0.0001), respiratory failure (p = 0.0001) and left ventricular failure (p = 0.017) were associated with higher average hospital charge. The absence of any complication predicted a lower average charge, and postoperative death (4.4 +/- 4.5 days after surgery) was also associated with lower average charge. A cost equation was developed: hospital charge equalled $11,217 + $41,559 of sternal wound infection, + $28,756 for respiratory failure, + $5,186 for left ventricular failure, - $1,798 for no complication and - $6,019 for death. Recognition of the influence of complications on charges suggests that low average charges can only be achieved by surgical programs with a low complication rate.
Taylor
G J
GJ
Prairie Cardiovascular Center, Springfield, Illinois.
Mikell
F L
FL
Moses
H W
HW
Dove
J T
JT
Katholi
R E
RE
Malik
S A
SA
Markwell
S J
SJ
Korsmeyer
C
C
Schneider
J A
JA
Wellons
H A
HA
D000368:Aged; D001026:Coronary Artery Bypass / Q000191:economics*; D003362:Cost-Benefit Analysis; D005249:Fees and Charges / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007087:Illinois; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics*; D011446:Prospective Studies; D012044:Regression Analysis; D013530:Surgical Wound Infection / Q000191:economics