| Trade-offs between hospital charges and patient outcomes. | |
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MedLine Citation:
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PMID: 3132042 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The increasing cost of health care has focused attention on the trade-offs between health care expenditures and patient outcomes. In this study, hospital charges were contrasted with the health status at 1 year of follow-up of 549 patients admitted to a university hospital medical service. The findings related to short-term outcomes were consistent with those of other investigators: large expenditures were associated with patients who died in the hospital, especially those whose death was unexpected. Both 1-year survival and hospital charges were found to correlate with physician estimates of illness severity and prognosis at the time of admission. Patients considered not ill with a favorable prognosis had a mortality rate at 1 year of 3%, comprised 7% of the cohort and generated 2% of total charges. In contrast, patients considered severely ill with an unfavorable prognosis had a mortality rate of 65%, comprised 19% of the cohort and generated 30% of total charges. Nevertheless, 46% of the survivors in this latter group were considered to be functional and only mildly ill at 1 year of follow-up. The imprecision of clinical judgements at the time of admission in predicting long-term outcome argues for aggressive management of acutely hospitalized patients when there is any doubt about their prognosis. |
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Authors:
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P Pompei; M E Charlson; F L Sax; K Ales; C R MacKenzie; M Norton |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The American journal of the medical sciences Volume: 295 ISSN: 0002-9629 ISO Abbreviation: Am. J. Med. Sci. Publication Date: 1988 May |
Date Detail:
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Created Date: 1988-07-07 Completed Date: 1988-07-07 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370506 Medline TA: Am J Med Sci Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 418-23 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Cornell University Medical College, New York, New York. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Fees and Charges* Follow-Up Studies Health Expenditures Hospitalization / economics* Humans Mortality New York City Outcome and Process Assessment (Health Care) / economics* Prognosis Severity of Illness Index |
| Grant Support | |
ID/Acronym/Agency:
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240-84-0057//PHS HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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