Surgical management of congenital heart disease: correlation between hospital costs and the Aristotle complexity score.
BACKGROUND
Hospital costs are expected to correlate with clinical complexity. Do costs for congenital heart surgery correlate with Aristotle complexity scores?


METHODS
442 inpatient stays in 2008 were evaluated. Aristotle scores and levels were determined. Costs were estimated according to the German Institute for Hospital Reimbursement system. Pearson and Spearman R correlation coefficients and corresponding goodness-of-fit regression coefficients R2 were calculated.


RESULTS
Mean basic and comprehensive Aristotle scores were 7.60 +/- 2.74 and 9.23 +/- 2.94 points, respectively. Mean expenses per hospital stay amounted to 29,369 +/- 30,823 Euros. Aristotle basic and comprehensive scores and levels were positively correlated with hospital costs. With a Spearman R of 1 and related R2 of 0.9436, scores of the 6 Aristotle comprehensive levels correlated best. Mean hospital reimbursement was 26,412 +/- 17,962 Euros. Compensation was higher than expenses for patients in comprehensive levels 1 to 3, but much lower for those in levels 4 to 6.


CONCLUSIONS
Aristotle comprehensive complexity scores were highly correlated with hospital costs. The Aristotle score could be used as a scale to establish the correct reimbursement after congenital heart surgery.
Sinzobahamvya
N
N
Pediatric Cardio-Thoracic Surgery, Deutsches Kinderherzzentrum Sankt Augustin, Sankt Augustin, Germany. n.sinzobahamvya@asklepios.com
Kopp
T
T
Photiadis
J
J
Arenz
C
C
Schindler
E
E
Haun
C
C
Hraska
V
V
Asfour
B
B
D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000191:economics* / Q000401:mortality; D003422:Critical Care / Q000191:economics; D005858:Germany; D006330:Heart Defects, Congenital / Q000191:economics* / Q000401:mortality / Q000601:surgery*; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D018803:Models, Economic; D012121:Respiration, Artificial / Q000191:economics; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome