Document Detail

Trade-offs between hospital charges and patient outcomes.
MedLine Citation:
PMID:  3132042     Owner:  NLM     Status:  MEDLINE    
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.
P Pompei; M E Charlson; F L Sax; K Ales; C R MacKenzie; M Norton
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
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:
Created Date:  1988-07-07     Completed Date:  1988-07-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  418-23     Citation Subset:  AIM; IM    
Department of Medicine, Cornell University Medical College, New York, New York.
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MeSH Terms
Fees and Charges*
Follow-Up Studies
Health Expenditures
Hospitalization / economics*
New York City
Outcome and Process Assessment (Health Care) / economics*
Severity of Illness Index
Grant Support
240-84-0057//PHS HHS

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

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