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Association of Hospital Prices for Coronary Artery Bypass Grafting With Hospital Quality and Reimbursement.
Giacomino, Bria D; Cram, Peter; Vaughan-Sarrazin, Mary; Zhou, Yunshu; Girotra, Saket.
Afiliación
  • Giacomino BD; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Electronic address: bria-giacomino@uiowa.edu.
  • Cram P; Division of General Internal Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario.
  • Vaughan-Sarrazin M; Department of Comprehensive Access and Delivery Research and Evaluation Center, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa.
  • Zhou Y; Department of Internal Medicine, Institute of Clinical & Translational Science, University of Iowa Carver College of Medicine, Iowa City, Iowa.
  • Girotra S; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa.
Am J Cardiol ; 117(7): 1101-6, 2016 Apr 01.
Article en En | MEDLINE | ID: mdl-26993975
Although prices for medical services are known to vary markedly between hospitals, it remains unknown whether variation in hospital prices is explained by differences in hospital quality or reimbursement from major insurers. We obtained "out-of-pocket" price estimates for coronary artery bypass grafting (CABG) from a random sample of US hospitals for a hypothetical patient without medical insurance. We compared hospital CABG price to (1) "fair price" estimate from Healthcare Bluebook data using each hospital's zip code and (2) Society of Thoracic Surgeons composite CABG quality score and risk-adjusted mortality rate. Of 101 study hospitals, 53 (52.5%) were able to provide a complete price estimate for CABG. The mean price for CABG was $151,271 and ranged from $44,824 to $448,038. Except for geographic census region, which was weakly associated with price, hospital CABG price was not associated with other structural characteristics or CABG volume (p >0.10 for all). Likewise, there was no association between a hospital's price for CABG with average reimbursement from major insurers within the same zip code (ρ = 0.07, p value = 0.6), Society of Thoracic Surgeoncomposite quality score (ρ = 0.08, p value = 0.71), or risk-adjusted CABG mortality (ρ = -0.03 p value = 0.89). In conclusion, the price of CABG varied more than 10-fold across US hospitals. There was no correlation between price information obtained from hospitals and the average reimbursement from major insurers in the same market. We also found no evidence to suggest that hospitals that charge higher prices provide better quality of care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de la Atención de Salud / Puente de Arteria Coronaria / Precios de Hospital / Reembolso de Seguro de Salud Tipo de estudio: Health_economic_evaluation / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Am J Cardiol Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de la Atención de Salud / Puente de Arteria Coronaria / Precios de Hospital / Reembolso de Seguro de Salud Tipo de estudio: Health_economic_evaluation / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Am J Cardiol Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos