The contribution of complications to high resource utilization during congenital heart surgery admissions.
The contribution of complications to high resource utilization during congenital heart surgery admissions.
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DOI：
10.1111/j.1747-0803.2007.00119.x
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发表时间：
2007-09-01
影响因子：
0.3
通讯作者：
Jenkins, Kathy J
中科院分区：
文献类型：
--
作者：
Benavidez, Oscar J;Connor, Jean A;Jenkins, Kathy J
背景：医学研究所估计，患者安全事件每年花费美国170亿至290亿美元。与患者安全事件或先天性心脏手术入院中并发症相关的成本被研究研究。 '2000年住院数据库年。先天性心脏手术病例或= $ 192,272。高资源入学率占所有入学总收费的40％。在3360（32％）的先天性心脏手术入院中发现并发症。单变量分析表明，至少有1个并发症诊断的入院更有可能是很高的资源使用（18％比6％或3.0，p <0.001）。多元分析表明，并发症诊断的入院可能更可能超过高资源利用率的阈值（OR 3.2，p <0.001）。在多元模型中增加并发症变量增加了ROC曲线下的面积从0.837增加到0.863。结论：先天性心脏手术接受并发症诊断的可能性超过192 272美元的总费用，尽管已知的已知风险因素调整了总费用用于高资源使用。减少并发症可能会导致经济和临床利益。
BACKGROUND: The Institutes of Medicine estimates that patient safety events cost the United States between $17 billion and $29 billion annually. Costs associated with patient safety events or complications among congenital heart surgery admissions are understudied.OBJECTIVE: To determine the independent contribution of complications on increased resource utilization during congenital heart surgery admissions.DESIGN/METHODS: Data were obtained from the Healthcare Cost and Utilization Project Kids' Inpatient Database year 2000. Cases of congenital heart surgery or=$192,272. High resource admissions accounted for >40% of the total charges for all admissions. Complications were identified in 3360 (32%) of congenital heart surgery admissions. Univariate analysis demonstrated that admissions with at least 1 complication diagnosis were more likely to be a high resource use admission (18% vs. 6%, OR 3.0, P < 0.001). Multivariate analyses revealed that admissions with a complication diagnosis were much more likely to exceed the threshold for high resource utilization (OR 3.2, P < 0.001). The addition of the complication variable to the multivariate model increased the area under the ROC curve from 0.837 to 0.863.CONCLUSIONS: Congenital heart surgery admissions with a complication diagnosis are 3 times more likely to exceed $192 272 in total charges despite adjusting for known risk factors for high resource use. Complication reduction may result in both an economic and clinical benefit.