Marginal Hospital Cost of Surgery-related Hospital-acquired Pressure Ulcers
| Autor: | Pamela L Owens, William D. Spector, Rhona Limcangco, Claudia A Steiner |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Marginal cost medicine.medical_specialty Adolescent Databases Factual Iatrogenic Disease MEDLINE Medicare Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Iatrogenic disease Humans Medicine 030212 general & internal medicine Hospital Costs Young adult Adverse effect Aged Retrospective Studies Aged 80 and over Pressure Ulcer business.industry 030503 health policy & services Public Health Environmental and Occupational Health Retrospective cohort study Hospital cost Length of Stay Middle Aged Surgical procedures United States Surgery Surgical Procedures Operative Regression Analysis Female 0305 other medical science business |
| Zdroj: | Medical Care. 54:845-851 |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/mlr.0000000000000558 |
| Popis: | Patients who develop hospital-acquired pressure ulcers (HAPUs) are more likely to die, have longer hospital stays, and are at greater risk of infections. Patients undergoing surgery are prone to developing pressure ulcers (PUs).To estimate the hospital marginal cost of a HAPU for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics.Data are from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and the Medicare Patient Safety Monitoring System for 2011 and 2012. PU information was obtained using retrospective structured record review from trained MPMS data abstractors. Costs are derived using HCUP hospital-specific cost-to-charge ratios. Marginal cost estimates were made using Extended Estimating Equations. We estimated the marginal cost at the 25th, 50th, and 75th percentiles of the cost distribution using Simultaneous Quantile Regression.We find that 3.5% of major surgical patients developed HAPUs and that the HAPUs added ∼$8200 to the cost of a surgical stay after adjusting for comorbidities, patient characteristics, procedures, and hospital characteristics. This is an ∼44% addition to the cost of a major surgical stay but less than half of the unadjusted cost difference. In addition, we find that for high-cost stays (75th percentile) HAPUs added ∼$12,100, whereas for low-cost stays (25th percentile) HAPUs added ∼$3900.This paper suggests that HAPUs add ∼44% to the cost of major surgical hospital stays, but the amount varies depending on the total cost of the visit. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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