Key result
Surgical cost and recent one-year medical costs before CABG were the most crucial predicting factors for one-year medical costs after discharge following isolated CABG.
Why the study?
Coronary artery bypass grafting entails high medical costs, and identifying drivers of cost variability is essential for health policy and quality of care.
What are the driving factors of in-hospital and one-year medical costs after isolated CABG?
Cohort
Yes
What are the driving factors of in-hospital and one-year medical costs after isolated CABG?
Patient characteristics, comorbidities, and hospital-related factors (including surgeon volume and age) significantly influence the medical costs associated with CABG, with prior medical costs being a key predictor of future costs.
May inform preoperative cost-risk counseling after isolated CABG; leaves open prospective validation and intervention trials.
In the aging world, coronary artery disease is the leading cardiovascular disease burden. Coronary artery bypass surgery grafting (CABG) entails high medical costs. Identifying the driving factors of medical cost variability is essential for health policies and the enhancement of quality of care. We conducted this study using data from the National Health Insurance Research Database (NHIRD) in the Longitudinal Health Insurance Database 2005, which includes 1 million randomly selected individuals from the 2005 registry of beneficiaries for their medical records collected between January 2000 and December 2013. We analyzed the in-hospital and one-year follow-up medical costs of patients with isolated CABG. Multiple linear regression models were developed to identify the effects of patient characteristics, comorbidities, and hospital-related factors on the surgical costs and the total one-year medical costs after discharge.Female patients had significantly higher surgical costs and higher one-year medical costs after discharge. Hospital volume, surgeon’s age, surgeon’s operation volume and the number of anastomosis vessels affected CABG outcomes considerably. Both the surgeon’s age and volume negatively affected the one-year medical costs after discharge. Charlson comorbidity index (CCI), recent one-year medical costs before surgery, emergency surgery and extracorporeal membrane oxygenation (ECMO) use were correlated with higher one-year medical costs after discharge. Using multiple linear regression models could explain part of the variances for the one-year medical costs after discharge using fewer factors. We found that surgical cost and recent one-year medical costs before CABG were the most crucial predicting factors for the one-year medical costs after discharge. Cost analysis about the variations of in-hospital and recent one-year costs before CABG is essential information for determining health policy and further improving clinical quality.
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Lee et al. (2020) conducted a cohort in Coronary artery disease requiring isolated CABG. Patient, surgeon, and hospital-related factors was evaluated on In-hospital surgical costs and one-year medical costs after discharge. Surgical cost and recent one-year medical costs before CABG were the most crucial predicting factors for one-year medical costs after discharge following isolated CABG.
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