Journal article
Cost of hospital care for older adults with heart failure: medical, pharmaceutical, and nursing costs
Health services research, Vol.43(2), pp.635-655
04/2008
DOI: 10.1111/j.1475-6773.2007.00789.x
PMCID: PMC2442365
PMID: 18370971
Abstract
To determine the impact of patient characteristics, clinical conditions, hospital unit characteristics, and health care interventions on hospital cost of patients with heart failure. Data for this study were part of a larger study that used electronic clinical data repositories from an 843-bed, academic medical center in the Midwest. This retrospective, exploratory study used existing administrative and clinical data from 1,435 hospitalizations of 1,075 patients 60 years of age or older. A cost model was tested using generalized estimating equations (GEE) analysis. Electronic databases used in this study were the medical record abstract, the financial data repository, the pharmacy repository; and the Nursing Information System repository. Data repositories were merged at the patient level into a relational database and housed on an SQL server. The model accounted for 88 percent of the variability in hospital costs for heart failure patients 60 years of age and older. The majority of variables that were associated with hospital cost were provider interventions. Each medical procedure increased cost by $623, each unique medication increased cost by $179, and the addition of each nursing intervention increased cost by $289. One medication and several nursing interventions were associated with lower cost. Nurse staffing below the average and residing on 2-4 units increased hospital cost. The model and data analysis techniques used here provide an innovative and useful methodology to describe and quantify significant health care processes and their impact on cost per hospitalization. The findings indicate the importance of conducting research using existing clinical data in health care.
Details
- Title: Subtitle
- Cost of hospital care for older adults with heart failure: medical, pharmaceutical, and nursing costs
- Creators
- Marita G Titler - Research, Quality and Outcomes Management, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, RM T100 GH, Iowa City, IA, USAGwenneth A JensenJoanne McCloskey DochtermanXian-Jin XieMary KanakDavid ReedLeah L Shever
- Resource Type
- Journal article
- Publication Details
- Health services research, Vol.43(2), pp.635-655
- DOI
- 10.1111/j.1475-6773.2007.00789.x
- PMID
- 18370971
- PMCID
- PMC2442365
- NLM abbreviation
- Health Serv Res
- ISSN
- 0017-9124
- eISSN
- 1475-6773
- Publisher
- United States
- Grant note
- R01 NR005331 / NINR NIH HHS
- Language
- English
- Date published
- 04/2008
- Academic Unit
- Preventive and Community Dentistry; Health Management and Policy; Biostatistics; Nursing; Dental Research
- Record Identifier
- 9983917793802771
Metrics
33 Record Views