Best of the 2012 Academy Health Annual Research Meeting
What Hospital Inpatient Services Contributed the Most to the 2001–2006 Growth in the Cost per Case?
Article first published online: 4 SEP 2012
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 5, pages 1814–1835, October 2012
How to Cite
Maeda, J. L. K., Raetzman, S. O. and Friedman, B. S. (2012), What Hospital Inpatient Services Contributed the Most to the 2001–2006 Growth in the Cost per Case?. Health Services Research, 47: 1814–1835. doi: 10.1111/j.1475-6773.2012.01460.x
- Issue published online: 17 SEP 2012
- Article first published online: 4 SEP 2012
- Agency for Healthcare Research and Quality. Grant Number: HHSA-290-2006-00009-C
To demonstrate a refined cost-estimation method that converts detailed charges for inpatient stays into costs at the department level to enable analyses that can unravel the sources of rapid growth in inpatient costs.
Healthcare Cost and Utilization Project State Inpatient Databases and Medicare Cost Reports for all community, nonrehabilitation hospitals in nine states that reported detailed charges in 2001 and 2006 (n = 10,280,416 discharges).
We examined the cost per discharge across all discharges and five subgroups (medical, surgical, congestive heart failure, septicemia, and osteoarthritis).
Data Collection/Extraction Methods
We created cost-to-charge ratios (CCRs) for 13 cost-center or department-level buckets using the Medicare Cost Reports. We mapped service-code-level charges to a CCR with an internally developed crosswalk to estimate costs at the service-code level.
Supplies and devices were leading contributors (24.2 percent) to the increase in mean cost per discharge across all discharges. Intensive care unit and room and board (semiprivate) charges also substantially contributed (17.6 percent and 11.3 percent, respectively). Imaging and other advanced technological services were not major contributors (4.9 percent).
Payers and policy makers may want to explore hospital stay costs that are rapidly rising to better understand their increases and effectiveness.