Effects of Preoperative Risk Stratification on Direct In-hospital Costs for Chinese Patients with Coronary Artery Bypass Graft:A Single Center Analysis
作者机构：Department of Cardiovascular SurgeryXinqiao HospitalArmy Medical UniversityChongqing 400037China Southwest HospitalArmy Medical UniversityChongqing 400038China
出 版 物：《Current Medical Science》 (当代医学科学（英文）)
年 卷 期：2018年第38卷第6期
页 面：1075-1080页
核心收录：
学科分类：0710[理学-生物学] 1001[医学-基础医学(可授医学、理学学位)] 0703[理学-化学] 10[医学]
主 题：coronary artery bypass graft risk stratification hospital costs medical insurance payment
摘 要：The purpose of this study was to analyze the components of inpatient costs for coronary artery bypass graft(CABG)according to preoperative risk stratification and to provide evidence for improvement of diagnosis-related groups(DRGs)payment.All patients(n=458)receiving an isolated CABG between January 2014 and December 2016 in a tertiary referral center,in southwest China,were analyzed.Hospital mortality was predicted by the EuroSCORE Ⅱ for each patient. The patients were subdivided into two groups according to the observed mortality(1.97%,9/458):a high-risk group(group H,predicted mortality≥1.97%)and a low-risk group(group L,predicted mortality1.97%).Clinical outcomes,resource use,in-hospital direct costs,and reimbursement expenses were compared between the two groups.Significant differences existed between group L and group H in postoperative mortality(0.4% vs.3.4%;P=0.02),postoperative complications(10.6% vs.45.7%;P0.001),postoperative length of hospital stay(17.5±4.9 days vs.18.8±6.5 days,P=0.01),in-hospital costs($20 256±3096vs.$23 334±6332;P0.001),and reimbursement expenses($7775±2627 vs.$9639±3917;P0.001).In general,a higher EuroSCORE Ⅱ was significantly associated with a worse clinical outcome and increased costs.The CABG cost data provide evidence for improvement of DRGs payment. Key words:coronary artery bypass graft;risk stratification;hospital costs;medical insurance
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