title: Why do patients having coronary artery bypass grafts have different costs or length of stay? An analysis across 10 European countries.
abstract: We analyse variations in cost or length of stay (LoS) for 66,587 patients from 10 European countries receiving a coronary artery bypass graft (CABG) procedure. In five of these countries, variations in cost are analysed using log-linear models. In the other five countries, negative binomial regression models are used to explore variations in LoS. We compare how well each country's diagnosis-related group (DRG) system and a set of patient-level characteristics explain these variations. The most important explanatory factors are the total number of diagnoses and procedures, although no clear effects are evident for our CABG-specific diagnostic and procedural variables. Wound infections significantly increase LoS and costs in most countries. There is no evidence that countries using larger numbers of DRGs to group CABG patients are better at explaining variations in cost or LoS. However, refinements to the construction of DRGs to group CABG patients might recognise first and subsequent CABGs or other specific surgical procedures, such as multiple valve repair.
authors: Centre for Health Economics, University of York, York, UK. james.gaughan@york.ac.uk
authors: James
authors: J
authors: Gaughan
authors: Conrad
authors: C
authors: Kobel
authors: Caroline
authors: C
authors: Linhart
authors: Anne
authors: A
authors: Mason
authors: Andrew
authors: A
authors: Street
authors: Padraic
authors: P
authors: Ward
mesh_terms: D000367:Age Factors; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000191:economics* / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D005060:Europe; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D018803:Models, Economic; D011183:Postoperative Complications / Q000191:economics; D012737:Sex Factors