Variation in Hospital Costs, Payments, and Profitabilty for Cardiac Valve Replacement Surgery
Variation in Hospital Costs, Payments, and Profitabilty for Cardiac Valve Replacement Surgery
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DOI：
10.1111/j.1475-6773.2011.01288.x
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发表时间：
2011-12-01
影响因子：
3.4
通讯作者：
Robinson, James C.
中科院分区：
文献类型：
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作者：
Robinson, James C.
目标。检查医疗保险和私人保险患者在医院费用、支付和贡献边际方面的差异，以及它们与患者、医院和医院市场特征的关联。数据源。2008年从7个州的37家医院获得了接受心脏瓣膜置换手术的1 858名患者的行政记录。研究设计。医疗保险和私人保险患者的成本、支付和盈利能力（贡献利润率）的双变量和多变量统计分析，根据患者、医院和市场特征进行调整。数据收集。综合医疗保健协会，阿斯彭健康指标，美国医院协会医院年度调查。主要的发现。心脏瓣膜置换术是一项昂贵但有利可图的手术，每例的平均费用和贡献边际分别为38,667美元和21,967美元。在调整了患者合并症、并发症和其他相关因素后，集中医疗保险患者的平均每例费用比竞争激烈的地方市场高16.1%
Objective. Examine the variation for Medicare and privately insured patients in hospital costs, payments, and contribution margins and their association with characteristics of the patients, hospitals, and hospital markets.Data Sources. Administrative records for 1,858 patients undergoing cardiac valve replacement surgery were obtained from 37 hospitals in 7 states for 2008.Study Design. Bivariate and multivariate statistical analyses of costs, payments, and profitability (contribution margin) for Medicare and privately insured patients, adjusting for patient, hospital, and market characteristics.Data Collection. Integrated Health Care Association, Aspen Health Metrics, American Hospital Association Annual Survey of Hospitals.Principal Findings. Cardiac valve replacement surgery is an expensive but profitable procedure, with average cost and contribution margin per case of U.S.$38,667 and U.S.$21,967, respectively. Average costs per case for Medicare patients are 16.1 percent higher in concentrated than in competitive local markets after adjusting for patient comorbidities, complications, and other relevant factors (p