title: What hospital inpatient services contributed the most to the 2001-2006 growth in the cost per case?
abstract: OBJECTIVE
  To demonstrate a refined cost-estimation method that converts detailed charges for inpatient stays into costs at the department level to enable analyses that can unravel the sources of rapid growth in inpatient costs.
  
  
  METHODS
  Healthcare Cost and Utilization Project State Inpatient Databases and Medicare Cost Reports for all community, nonrehabilitation hospitals in nine states that reported detailed charges in 2001 and 2006 (n = 10,280,416 discharges).
  
  
  METHODS
  We examined the cost per discharge across all discharges and five subgroups (medical, surgical, congestive heart failure, septicemia, and osteoarthritis).
  
  
  METHODS
  We created cost-to-charge ratios (CCRs) for 13 cost-center or department-level buckets using the Medicare Cost Reports. We mapped service-code-level charges to a CCR with an internally developed crosswalk to estimate costs at the service-code level.
  
  
  RESULTS
  Supplies and devices were leading contributors (24.2 percent) to the increase in mean cost per discharge across all discharges. Intensive care unit and room and board (semiprivate) charges also substantially contributed (17.6 percent and 11.3 percent, respectively). Imaging and other advanced technological services were not major contributors (4.9 percent).
  
  
  CONCLUSIONS
  Payers and policy makers may want to explore hospital stay costs that are rapidly rising to better understand their increases and effectiveness.
authors.affiliation: Analytic Consulting & Research Services, Truven Health Analytics, Washington, DC, USA. jared.maeda@truvenhealth.com
authors.forename: Jared Lane K
authors.initials: JL
authors.lastname: Maeda
authors.forename: Susan O
authors.initials: SO
authors.lastname: Raetzman
authors.forename: Bernard S
authors.initials: BS
authors.lastname: Friedman
mesh_terms: D006333:Heart Failure / Q000191:economics; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006748:Hospital Departments / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000191:economics; D010003:Osteoarthritis / Q000191:economics; D010351:Patient Discharge / Q000191:economics; D010362:Patients' Rooms / Q000191:economics; D018805:Sepsis / Q000191:economics; D013514:Surgical Procedures, Operative / Q000191:economics