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What Hospital Inpatient Services Contributed the Most to the 2001–2006 Growth in the Cost per Case?
Author(s) -
Maeda Jared Lane K.,
Raetzman Susan O.,
Friedman Bernard S.
Publication year - 2012
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2012.01460.x
Subject(s) - cost estimate , medicine , unit (ring theory) , inpatient care , health care , medical emergency , emergency medicine , intensive care unit , diagnosis code , healthcare cost and utilization project , unit cost , operations management , environmental health , intensive care medicine , population , psychology , engineering , economics , mechanical engineering , mathematics education , systems engineering , economic growth
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. Data Sources H ealthcare C ost and U tilization P roject S tate I npatient D atabases and M edicare C ost R eports for all community, nonrehabilitation hospitals in nine states that reported detailed charges in 2001 and 2006 ( n = 10,280,416 discharges). Study Design We examined the cost per discharge across all discharges and five subgroups (medical, surgical, congestive heart failure, septicemia, and osteoarthritis). Data Collection/Extraction Methods We created cost‐to‐charge ratios ( CCR s) for 13 cost‐center or department‐level buckets using the M edicare C ost R eports. We mapped service‐code‐level charges to a CCR with an internally developed crosswalk to estimate costs at the service‐code level. Principal Findings 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.