Journal article
Assessment of Price Variation in Coronary Artery Bypass Surgery at US Hospitals
Journal of the American Heart Association, v 13(4), 031982
20 Feb 2024
PMID: 38362880
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Little is known about hospital pricing for coronary artery bypass grafting (CABG). Using new price transparency data, we assessed variation in CABG prices across US hospitals and the association between higher prices and hospital characteristics, including quality of care.
METHODS AND RESULTS: Prices for diagnosis related group code 236 were obtained from the Turquoise database and linked by Medicare Facility ID to publicly available hospital characteristics. Univariate and multivariable analyses were performed to assess factors predictive of higher prices. Across 544 hospitals, median commercial and self-pay rates were 2.01 and 2.64 times the Medicare rate ($ 57 240 and $75 047, respectively, versus $28 398). Within hospitals, the 90th percentile insurer-negotiated price was 1.83 times the 10th percentile price. Across hospitals, the 90th percentile commercial rate was 2.91 times the 10th percentile hospital rate. Regional median hospital prices ranged from $35 624 in the East South Central to $ 84 080 in the Pacific. In univariate analysis, higher inpatient revenue, greater annual discharges, and major teaching status were significantly associated with higher prices. In multivariable analysis, major teaching and investor-owned status were associated with significantly higher prices (+$8653 and +$12 200, respectively). CABG prices were not related to death, readmissions, patient ratings, or overall Centers for Medicare and Medicaid Services hospital rating.
CONCLUSIONS: There is significant variation in CABG pricing, with certain characteristics associated with higher rates, including major teaching status and investor ownership. Notably, higher CABG prices were not associated with better-quality care, suggesting a need for further investigation into drivers of pricing variation and the implications for health care spending and access.
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Details
- Title
- Assessment of Price Variation in Coronary Artery Bypass Surgery at US Hospitals
- Creators
- Chen Wei - Stanford UniversityIshan Paranjpe - Stanford UniversityPranav Sharma - Drexel UniversityMichael Milligan - Brigham and Women's HospitalMiranda Lam - Brigham and Women's HospitalPaul A. Heidenreich - VA Palo Alto Health Care SystemNeil Kalwani - VA Palo Alto Health Care SystemKevin Schulman - Stanford UniversityAlexander Sandhu - Stanford Medicine
- Publication Details
- Journal of the American Heart Association, v 13(4), 031982
- Publisher
- Wiley
- Number of pages
- 9
- Grant note
- 1K23HL151672-03 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001252881300021
- Scopus ID
- 2-s2.0-85185614467
- Other Identifier
- 991022202492004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems