Surgonomics: the cost of cholecystectomy.

摘要: Health care costs presently comprise more than one tenth of the nation's gross national product: One third these expenditures are made by Medicare-Medicaid. National reimbursement changes for Medicare under a Diagnostic-Related Group system began October 1, 1983. Hospital charges (excluding physician charges) all patients who underwent cholecystectomy without common bile duct exploration (Diagnostic-Related group 197 and 198) from Jan. 1983 to March 31, were examined quantify mean charges, variances, components hospital charges. Twenty-one (mean age 46.1 years) elective 24 64.9 emergency cholecystectomy. The charge was $4763 +/- $1656; length stay (LOS) 8.0 3.2 days. Low high trim points $3211 $10,639 5 19 days LOS. Quartile cost analysis per patient showed that Q1 = 18.5%, Q2 21.2%, Q3 24.0%, Q4 36.3%. Analysis services laboratory work (urinalysis, hematology, coagulation, microbiology, biochemistry) averaged $451 $298 (9.5% total), room board $2635 $1044 (55.3% operating recovery $924 $167 (19.4% central supply-pharmacy $350 $158 (7.4% total). undergoing $11,436 $4185; LOS 17.8 6.5 $6353 $19,734; 9 30 Services as percent total 15.8%, 53.7%, 9.14%, 7.3%, radiology 8.2%. Several important findings noted: (1) For given disease there is marked variance (2) Mean 240% patients. (3) Consumption varies significantly within each between groups. This study demonstrates importance in depth financial therapies. first step identify where reduction will not affect quality care.