title: Determinants of hospital charges for coronary artery bypass surgery: the economic consequences of postoperative complications.
abstract: 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.
authors.affiliation: Prairie Cardiovascular Center, Springfield, Illinois.
authors.forename: G J
authors.initials: GJ
authors.lastname: Taylor
authors.forename: F L
authors.initials: FL
authors.lastname: Mikell
authors.forename: H W
authors.initials: HW
authors.lastname: Moses
authors.forename: J T
authors.initials: JT
authors.lastname: Dove
authors.forename: R E
authors.initials: RE
authors.lastname: Katholi
authors.forename: S A
authors.initials: SA
authors.lastname: Malik
authors.forename: S J
authors.initials: SJ
authors.lastname: Markwell
authors.forename: C
authors.initials: C
authors.lastname: Korsmeyer
authors.forename: J A
authors.initials: JA
authors.lastname: Schneider
authors.forename: H A
authors.initials: HA
authors.lastname: Wellons
mesh_terms: 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