Length of stay has minimal impact on the cost of hospital admission1

Taheri, Paul A.; Butz, David A.; Greenfield, Lazar J.

doi:10.1016/s1072-7515(00)00352-5

Cited by 295 publications

(178 citation statements)

References 9 publications

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“…[14][15][16][17] Our study result shows that LOS for the two phases varied from 27 to 37 days ( Table 2). The differences between hospital LOS may in part be due to geographic factors.…”

Section: Length Of Stay (Los) Several Studies Have Investigatedmentioning

confidence: 79%

Cost of autologous peripheral blood stem cell transplantation: the Norwegian experience from a multicenter cost study

Mishra

Andresen

Brinch

et al. 2005

Bone Marrow Transplant

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Summary:High-dose therapy with autologous blood progenitor cell support is now routinely used for patients with certain malignant lymphomas and multiple myeloma. We performed a prospective cost analysis of the mobilization, harvesting and cryopreservation phases and the high-dose therapy with stem cell reinfusion and hospitalization phases. In total, 40 consecutive patients were studied at four different university hospitals between 1999 and 2001. Data on direct costs were obtained on a daily basis. Data on indirect costs were allocated to the specific patient based on estimates of relevant department costs (ie the service department's costs), and by means of predefined allocation keys. All cost data were calculated at 2001 prices. The mean total costs for the two phases were US$ 32 160 (range US$ 19 092-50 550). The mean total length of hospital stay for two phases was 31 days (range 27-37). A large part of the actual cost in the harvest phase was attributed to stem cell mobilization, including growth factors, harvesting and cryopreservation. In the high-dose chemotherapy phase, the most significant part of the costs was nursing staff. Average total costs were considerably higher than actual DRG-based reimbursement from the government, indicating that the treatment of these patients was heavily subsidized by the basic hospital grants.

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“…[14][15][16][17] Our study result shows that LOS for the two phases varied from 27 to 37 days ( Table 2). The differences between hospital LOS may in part be due to geographic factors.…”

Section: Length Of Stay (Los) Several Studies Have Investigatedmentioning

confidence: 79%

Cost of autologous peripheral blood stem cell transplantation: the Norwegian experience from a multicenter cost study

Mishra

Andresen

Brinch

et al. 2005

Bone Marrow Transplant

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“…Some researchers have suggested that reducing length of stay is not economically significant for the patient since the final day of hospitalization is only associated with 6.8% of the total cost for a patient whose length of stay is four days. 32 Considering the nation spent $11.9 billion on TKAs in 2003, a reduction of even 6.8% poses a significant cost-savings opportunity for the health care system. 33 Hospitals face a financial burden associated with unnecessarily long patient stays and have gradually discharged patients at earlier time points in recent years.…”

Section: Discussionmentioning

confidence: 99%

Patient vs Provider Characteristics Impacting Hospital Lengths of Stay After Total Knee or Hip Arthroplasty

Styron

Koroukian

Klika³

et al. 2011

The Journal of Arthroplasty

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“…1). The cost of a day in the hospital was based on reported values [64] and scaled by the consumer price index [69] to USD 699.…”

Section: Complication Rates and Length Of Staymentioning

confidence: 99%

“…Of the more successful models, two of the common features are (1) a shift in focus where both physicians act as a patient's primary caregiver as opposed to the traditional model of admission to a single service with the other service acting as a consultant, and (2) a shared goal that common medical and surgical complications should be anticipated rather than treated after their occurrence. This approach has decreased complication rates [5,17,22,45,64], time from injury until the operating room [4,24,52], hospital length of stay [5,17,24,28,39,40,52,70], and has improved osteoporosis treatment [22,28].…”

Section: Introductionmentioning

confidence: 99%

Dedicated Perioperative Hip Fracture Comanagement Programs are Cost-effective in High-volume Centers: An Economic Analysis

Swart

Vasudeva

Makhni

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Osteoporotic hip fractures are common injuries typically occurring in patients who are older and medically frail. Studies have suggested that creation of a multidisciplinary team including orthopaedic surgeons, internal medicine physicians, social workers, and specialized physical therapists, to comanage these patients can decrease complication rates, improve time to surgery, and reduce hospital length of stay; however, they have yet to achieve widespread implementation, partly owing to concerns regarding resource requirements necessary for a comanagement program. Questions/Purposes We performed an economic analysis to determine whether implementation of a comanagement model of care for geriatric patients with osteoporotic hip fractures would be a cost-effective intervention at hospitals with moderate volume. We also calculated what annual volume of cases would be needed for a comanagement program to ''break even'', and finally we evaluated whether universal or risk-stratified comanagement was more cost effective. Methods Decision analysis techniques were used to model the effect of implementing a systems-based strategy to improve inpatient perioperative care. Costs were obtained from best-available literature and included salary to support personnel and resources to expedite time to the operating room. The major economic benefit was decreased initial hospital length of stay, which was determined via literature review and meta-analysis, and a health benefit was improvement in perioperative mortality owing to expedited preoperative evaluation based on previously conducted meta-analyses. A break-even analysis was conducted to determine the annual case volume necessary for comanagement to be either (1) cost effective (improve health-related quality of life enough to be worth additional expenses) or (2) result in cost savings (actually result in decreased total expenses). This calculation assumed the scenario in which a hospital could hire only one hospitalist (and therapist and social worker) on a full-time basis. Additionally, we evaluated the scenario where the necessary staff was already employed at the hospital and could be dedicated to a comanagement service on a part-time basis, and explored the effect of triaging only patients considered high risk to a comanagement service versus comanaging all geriatric patients. Finally, probabilistic sensitivity analysis was conducted on all critical variables, with broad ranges used for values around which there was higher uncertainty. Results For the base case, universal comanagement was more cost effective than traditional care and risk-stratified comanagement (incremental cost effectiveness ratios of All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity...

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Length of stay has minimal impact on the cost of hospital admission1

Cited by 295 publications

References 9 publications

Cost of autologous peripheral blood stem cell transplantation: the Norwegian experience from a multicenter cost study

Cost of autologous peripheral blood stem cell transplantation: the Norwegian experience from a multicenter cost study

Patient vs Provider Characteristics Impacting Hospital Lengths of Stay After Total Knee or Hip Arthroplasty

Dedicated Perioperative Hip Fracture Comanagement Programs are Cost-effective in High-volume Centers: An Economic Analysis

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