Document Detail

Effect of patient factors on hospital costs for major bowel surgery: implications for managed health care.
MedLine Citation:
PMID:  7716727     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We examined the effects of patient factors on hospital resource consumption for patients who had undergone major bowel operation (diagnosis-related groups [DRGs] 148 and 149) at an urban, university hospital. METHODS: We performed cross-sectional analysis of computerized hospital discharge abstracts and charts of 491 consecutive discharges in these DRGs. Total hospital charges and length of stay were dependent variables. Independent variables included admission status, admission service, previous admissions, payer type, service type, diagnosis, reoperation, and death. RESULTS: Patient factors accounted for significant variability in resource consumption. By univariate analysis all of the above variables significantly affected total charges, and all but service type significantly affected length of stay. By multivariate analysis DRGs 148/149 alone explained 4.2% of the variance, whereas all the variables together increased R2 to 52.1%. Logistic regression of reoperation and of death as dependent variables suggested that patient factors also accounted for significant variance in these outcomes. CONCLUSIONS: Because patient factors may not be directly controllable by hospitals or physicians, differences among hospitals in costs and in "quality" may relate more to differences in patient mix than to efficiency. DRGs alone are not a sufficient management tool, and additional measures are needed to adequately measure both efficiency and quality.
R S Rhodes; P D Sharkey; S D Horn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  117     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1995-05-12     Completed Date:  1995-05-12     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  443-50     Citation Subset:  AIM; IM    
Department of Surgery, University of Mississippi Medical Center, Jackson 39216-4505, USA.
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MeSH Terms
Age Factors
Analysis of Variance
Costs and Cost Analysis
Diagnosis-Related Groups / economics*
Economics, Hospital*
Hospitals, University / economics
Hospitals, Urban / economics
Intestinal Diseases / economics*,  surgery*
Multivariate Analysis
Regression Analysis
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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