title: A cross-sectional analysis of variation in charges and prices across California for percutaneous coronary intervention.
abstract: BACKGROUND
  Though past studies have shown wide variation in aggregate hospital price indices and specific procedures, few have documented or explained such variation for distinct and common episodes of care.
  
  
  OBJECTIVE
  We sought to examine the variability in charges for percutaneous coronary intervention (PCI) with a drug-eluting stent and without major complications (MS-DRG-247), and determine whether hospital and market characteristics influenced these charges.
  
  
  METHODS
  We conducted a cross-sectional analysis of adults admitted to California hospitals in 2011 for MS-DRG-247 using patient discharge data from the California Office of Statewide Health Planning and Development. We used a two-part linear regression model to first estimate hospital-specific charges adjusted for patient characteristics, and then examine whether the between-hospital variation in those estimated charges was explained by hospital and market characteristics.
  
  
  RESULTS
  Adjusted charges for the average California patient admitted for uncomplicated PCI ranged from $22,047 to $165,386 (median: $88,350) depending on which hospital the patient visited. Hospitals in areas with the highest cost of living, those in rural areas, and those with more Medicare patients had higher charges, while government-owned hospitals charged less. Overall, our model explained 43% of the variation in adjusted charges. Estimated discounted prices paid by private insurers ranged from $3,421 to $80,903 (median: $28,571).
  
  
  CONCLUSIONS
  Charges and estimated discounted prices vary widely between hospitals for the average California patient undergoing PCI without major complications, a common and relatively homogeneous episode of care. Though observable hospital characteristics account for some of this variation, the majority remains unexplained.
authors.affiliation: Department of Emergency Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Renee Y
authors.initials: RY
authors.lastname: Hsia
authors.affiliation: Department of Economics, Indiana University Purdue University, Indianapolis, Indiana, United States of America.
authors.forename: Yaa
authors.initials: Y
authors.lastname: Akosa Antwi
authors.affiliation: School of Public Health, University of Texas, Houston, Texas, United States of America.
authors.forename: Ellerie
authors.initials: E
authors.lastname: Weber
authors.affiliation: Department of Emergency Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Julia
authors.initials: J
authors.lastname: Brownell Nath
mesh_terms: D000328:Adult; D000368:Aged; D002140:California; D003430:Cross-Sectional Studies; D005260:Female; D017722:Hospital Charges; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000191:economics*
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