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Determinants of costs and resource utilization associated with open heart surgery

Sokolovic, E. ; Schmidlin, D. ; Schmid, E.R. ; Turina, M. ; Ruef, C. ; Schwenkglenks, M. ; Szucs, T.D.

In: European Heart Journal, 2002, vol. 23, no. 7, p. 574-578

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    Titel
    • Determinants of costs and resource utilization associated with open heart surgery
    Autor
    • Sokolovic, E.. Department of Medical Economics, University Hospital, Zurich, Switzerland
    • Schmidlin, D.. Division of Cardiovascular Anaesthesia, University Hospital, Zurich, Switzerland
    • Schmid, E.R.. Division of Cardiovascular Anaesthesia, University Hospital, Zurich, Switzerland
    • Turina, M.. Clinic of Cardiovascular Surgery, University Hospital, Zurich, Switzerland
    • Ruef, C.. Department of Hospital Hygiene, University Hospital, Zurich, Switzerland
    • Schwenkglenks, M.. Department of Medical Economics, University Hospital, Zurich, Switzerland
    • Szucs, T.D.. Department of Medical Economics, University Hospital, Zurich, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Heart Journal, 2002, vol. 23, no. 7, p. 574-578. Oxford University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:295210
    Summary
    Aims This study sought to determine the patient- and the therapy-related determinants of in-hospital costs for patients undergoing heart surgery at the University Hospital in Zurich. Methods and Results We performed a retrospective analysis of all adult cardiac surgical patients from the canton St. Gallen who were covered by a fixed fee arrangement (29500 Swiss francs (19470 Euro)) and referred to our institution during 1998. A total of 201 patients (143 (71%) male) with basic insurance were hospitalized in 1998 under the fixed fee arrangement. The mean age of the patients was 61·4 years (95% confidence intervals (CI): 60; 63). With the help of univariate analysis, the following pre-operative characteristics were found to be significantly associated with cost: age (P<0·001), pre-operative cardiac diagnosis (coronary vs valvular heart disease) (P<0·001) and EuroSCORE (P<0·0001). A significant correlation was also found between intra-operative variables and costs (P<0·0001) as well as between postoperative variables and costs (P<0·0001). A linear regression model based on EuroSCORE, operation time and postoperative infection status is able to predict costs for patients (all P -values <0·0001, except for P<0·05 for operation time, R2=0·565). Conclusions These results suggest that both pre-operative (patient related) and intra-operative (therapy- and patient-related) variables are predictors of costs in cardiac surgical patients