title: Factors affecting profitability for craniotomy.
abstract: OBJECTIVE
  The authors studied factors influencing hospital profitability after craniotomy in patients who underwent craniotomy coded as diagnosis-related group (DRG) 1 (17 years of age with nontraumatic disease without complication) and who met their hospital's craniotomy pathway criteria and had a hospital length of stay 4 days or less during a 20-month period.
  
  
  METHODS
  Data in all patients meeting these criteria (76 cases) were collected and collated from various hospital databases. Twenty-one cases were profitable and 55 were not. Variables traditionally influencing cost of care, such as surgeon, procedure, length of operation, and pharmacy use had no significant effect on whether a patient was profitable. The most important influence on profitability was the individual payor. Cases in which care was reimbursed under the prospective payment system based on DRGs were nearly always profitable whereas those covered by per diem plans were nearly always nonprofitable.
  
  
  CONCLUSIONS
  1) Hospital information systems should be customized to deliver consolidated data for timely analysis of cost of care for individual patients. This information may be useful in negotiating profitable contracts. 2) A clinical pathway was successful in reducing the difference in cost of care between profitable and nonprofitable postcraniotomy cases. 3) In today's health care environment both cost containment and revenue assume importance in determining profitability.
authors.affiliation: Division of Neurosurgery, Albany Medical College, New York 12208, USA. poppj@mail.amc.edu
authors.forename: A John
authors.initials: AJ
authors.lastname: Popp
authors.forename: Todd
authors.initials: T
authors.lastname: Scrime
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Cohen
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Feustel
authors.forename: Karen
authors.initials: K
authors.lastname: Petronis
authors.forename: Sharon
authors.initials: S
authors.lastname: Habiniak
authors.forename: John B
authors.initials: JB
authors.lastname: Waldman
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Vosburgh
mesh_terms: D000293:Adolescent; D016001:Confidence Intervals; D003365:Costs and Cost Analysis / Q000379:methods / Q000706:statistics & numerical data; D003399:Craniotomy / Q000191:economics* / Q000706:statistics & numerical data*; D016208:Databases, Factual; D006801:Humans; D016014:Linear Models; D016017:Odds Ratio; D018709:Statistics, Nonparametric