Procedure intensity and the cost of care.

Circulation. Cardiovascular Quality and Outcomes
Serene I ChenTara Lagu

Abstract

The intensive practice style of hospitals with high procedure rates may result in higher costs of care for medically managed patients. We sought to determine how costs for patients with heart failure (HF) not receiving procedures compare between hospital groups defined by their overall use of procedures. We identified all 2009 to 2010 adult HF hospitalizations in hospitals capable of performing invasive procedures that had at least 25 HF hospitalizations in the Perspective database from Premier, Inc. We divided hospitals into 2 groups by the proportion of patients with HF receiving invasive percutaneous or surgical procedures: low (>0%-10%) and high (≥ 10%). The standard costs of hospitalizations at each hospital were risk adjusted using patient demographics and comorbidities. We used the Wilcoxon rank sum test to assess cost, length of stay, and mortality outcome differences between the 2 groups. Median risk-standardized costs among low-procedural HF hospitalizations were $5259 (interquartile range, $4683-$6814) versus $6965 (interquartile range, $5981-$8235) for hospitals with high procedure use (P<0.001). Median length of stay was 4 days for both groups. Risk-standardized mortality rates were 5.4% (low procedure) and 5.0% (h...Continue Reading

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Citations

Jul 13, 2013·The Journal of Arthroplasty·Yue LiPeter Cram
Jun 1, 2013·Healthcare : the Journal of Delivery Science and Innovation·Tara LaguPeter K Lindenauer
Jun 13, 2013·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Tara LaguPeter K Lindenauer
Jul 1, 2014·Health Services Research·Xiao XuHarlan M Krumholz
Mar 19, 2014·Circulation. Heart Failure·Vivek T KulkarniHarlan M Krumholz

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