Determinants of hospital charges for coronary artery bypass surgery: The economic consequences of postoperative complications

https://doi.org/10.1016/0002-9149(90)90293-AGet rights and content

Abstract

This is a prospective study of 500 consecutive patients having coronary artery bypass surgery; mean hospital charge from time of surgery to discharge was $11,900 ± 12,700. Multiple regression analysis was performed using preoperative variables and postoperative complications. No preoperative clinical feature was a significant predictor of higher average charge. Sternal wound infection (p = 0.0001), respiratory failure (p = 0.0001) and left ventricular failure (p = 0.017) were associated with higher average hospital charge. The absence of any complication predicted a lower average charge, and postoperative death (4.4 ± 4.5 days after surgery) was also associated with lower average charge. A cost equation was developed: hospital charge equalled $11,217 + $41,559 for sternal wound infection, + $28,756 for respiratory failure, + $5,186 for left ventricular failure, − $1,798 for no complication and − $6,019 for death. Recognition of the influence of complications on charges suggests that low average charges can only be achieved by surgical programs with a low complication rate.

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