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Estimating cost savings from regionalizing cardiac procedures using hospital discharge data.

Ho V, Petersen LA - Cost Eff Resour Alloc (2007)

Bottom Line: Despite these lower costs, the predicted savings from regionalizing all PCI procedures in the sample from lower to high-volume hospitals amounted to only 1.1% of the entire costs of performing PCI procedures for the sample in 2000.Similarly, the cost savings for CABG were estimated to be only 3.5%.However, the total potential savings from regionalizing cardiac procedures is relatively minor, and may not justify the risks of reducing access to needed services.

View Article: PubMed Central - HTML - PubMed

Affiliation: Baker Institute, Rice University, 6100 Main Street, Houston, TX 77005, USA. vho@rice.edu

ABSTRACT

Background: We examined whether higher procedure volumes for coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions (PCI) were associated with lower costs per patient, and if so, estimated the financial savings from regionalizing cardiac procedures.

Methods: Cost regressions with hospital-specific dummy variables measured within-hospital cost reductions associated with increasing hospital volume. We used the regression estimates to predict the change in total costs that would result from moving patients in low-volume hospitals to higher volume facilities.

Results: A 10% increase in PCI procedure volume lowered costs per patient by 0.7%. For the average hospital performing CABG in 2000, a 10% increase in volume was associated with a 2.8% reduction in average costs. Despite these lower costs, the predicted savings from regionalizing all PCI procedures in the sample from lower to high-volume hospitals amounted to only 1.1% of the entire costs of performing PCI procedures for the sample in 2000. Similarly, the cost savings for CABG were estimated to be only 3.5%.

Conclusion: Higher volumes were associated with lower costs per procedure. However, the total potential savings from regionalizing cardiac procedures is relatively minor, and may not justify the risks of reducing access to needed services.

No MeSH data available.


Related in: MedlinePlus

Actual costs and predicted results of closing lower volume hospitals and redirecting patients to higher volume facilities in 2000. a Predictions of total costs and patients affected if patients in low-volume hospitals were instead treated in a hospital with the median procedure volume of medium and high-volume hospitals in year 2000. b Predictions of total costs and patients affected if patients in low and medium-volume hospitals were instead treated in a hospital with the median procedure volume of high-volume hospitals in year 2000.
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Figure 1: Actual costs and predicted results of closing lower volume hospitals and redirecting patients to higher volume facilities in 2000. a Predictions of total costs and patients affected if patients in low-volume hospitals were instead treated in a hospital with the median procedure volume of medium and high-volume hospitals in year 2000. b Predictions of total costs and patients affected if patients in low and medium-volume hospitals were instead treated in a hospital with the median procedure volume of high-volume hospitals in year 2000.

Mentions: We used the regression estimates to predict the change in costs that would result from eliminating PCI and CABG in low-volume hospitals and moving these patients instead to higher volume hospitals (Figure 1). A total of 17,236 PCI patients out of 509,491 (3.4%) were treated in low-volume hospitals in the year 2000. Among medium and high-volume hospitals in the sample in 2000, the median PCI procedure volume was 539. If these 17,236 patients had instead been treated in a hospital which performed 539 PCI procedures per year, the regression estimates indicate that the total costs of caring for these patients would be lowered by $22.1 million.


Estimating cost savings from regionalizing cardiac procedures using hospital discharge data.

Ho V, Petersen LA - Cost Eff Resour Alloc (2007)

Actual costs and predicted results of closing lower volume hospitals and redirecting patients to higher volume facilities in 2000. a Predictions of total costs and patients affected if patients in low-volume hospitals were instead treated in a hospital with the median procedure volume of medium and high-volume hospitals in year 2000. b Predictions of total costs and patients affected if patients in low and medium-volume hospitals were instead treated in a hospital with the median procedure volume of high-volume hospitals in year 2000.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1919355&req=5

Figure 1: Actual costs and predicted results of closing lower volume hospitals and redirecting patients to higher volume facilities in 2000. a Predictions of total costs and patients affected if patients in low-volume hospitals were instead treated in a hospital with the median procedure volume of medium and high-volume hospitals in year 2000. b Predictions of total costs and patients affected if patients in low and medium-volume hospitals were instead treated in a hospital with the median procedure volume of high-volume hospitals in year 2000.
Mentions: We used the regression estimates to predict the change in costs that would result from eliminating PCI and CABG in low-volume hospitals and moving these patients instead to higher volume hospitals (Figure 1). A total of 17,236 PCI patients out of 509,491 (3.4%) were treated in low-volume hospitals in the year 2000. Among medium and high-volume hospitals in the sample in 2000, the median PCI procedure volume was 539. If these 17,236 patients had instead been treated in a hospital which performed 539 PCI procedures per year, the regression estimates indicate that the total costs of caring for these patients would be lowered by $22.1 million.

Bottom Line: Despite these lower costs, the predicted savings from regionalizing all PCI procedures in the sample from lower to high-volume hospitals amounted to only 1.1% of the entire costs of performing PCI procedures for the sample in 2000.Similarly, the cost savings for CABG were estimated to be only 3.5%.However, the total potential savings from regionalizing cardiac procedures is relatively minor, and may not justify the risks of reducing access to needed services.

View Article: PubMed Central - HTML - PubMed

Affiliation: Baker Institute, Rice University, 6100 Main Street, Houston, TX 77005, USA. vho@rice.edu

ABSTRACT

Background: We examined whether higher procedure volumes for coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions (PCI) were associated with lower costs per patient, and if so, estimated the financial savings from regionalizing cardiac procedures.

Methods: Cost regressions with hospital-specific dummy variables measured within-hospital cost reductions associated with increasing hospital volume. We used the regression estimates to predict the change in total costs that would result from moving patients in low-volume hospitals to higher volume facilities.

Results: A 10% increase in PCI procedure volume lowered costs per patient by 0.7%. For the average hospital performing CABG in 2000, a 10% increase in volume was associated with a 2.8% reduction in average costs. Despite these lower costs, the predicted savings from regionalizing all PCI procedures in the sample from lower to high-volume hospitals amounted to only 1.1% of the entire costs of performing PCI procedures for the sample in 2000. Similarly, the cost savings for CABG were estimated to be only 3.5%.

Conclusion: Higher volumes were associated with lower costs per procedure. However, the total potential savings from regionalizing cardiac procedures is relatively minor, and may not justify the risks of reducing access to needed services.

No MeSH data available.


Related in: MedlinePlus