Analysis of Micro-Costs of Coronary Artery ByPass Grafting. Abstract, Executive211 Summary and Final Report

摘要

Coronary artery bypass grafting (CABG) is one of the most common and costly211u001esurgical procedures. To control rising costs, Health Care Financing 211u001eAdministration began a demonstration in 1991 to pay hospitals and physicians a 211u001esingle negotiated global price for CABG patients. This study analyzed micro-cost 211u001eand clinical data of 2,828 CABG patients from three participating hospitals 211u001ebetween 1991 to 1993. This study focused on direct variable costs, the marginal 211u001ecosts of performing next CABG procedure. Major findings include: (1) All 211u001eparticipating hospitals significantly reduced total direct variable costs. The 211u001ereductions increased over time, primarily from nursing ICU, routine nursing, 211u001epharmacy, and catheterization lab; (2) The impact of risk factors on total cost 211u001eand direct variable costs were very similar in each hospital, but the impact of 211u001erisk factors differed substantially across hospitals; (3) The effects of 211u001epreoperative risk factors on direct variable costs differed across major 211u001edepartments, with more risk factors affecting nursing ICU and pharmacy than 211u001eroutine nursing, operation room (OR) and recovery, and catheter lab.