The Impact of Patient Characteristics on Total Hospital Cost in Patients Undergoing Coronary Artery Bypass Grafting

Abstract

Introduction

Coronary artery bypass graft (CABG) is one of the most common surgeries in the United States, with an average cost around $40,000. However, the burden of these costs may fall unequally among patients of different demographic groups. The objective of this study is to characterize factors associated with increased total cost after coronary artery bypass graft surgery.

Methods

The Statewide Planning and Research Cooperative System (SPARCS) database for years 2017–2021 was queried to identify patients who had undergone CABG in New York State. Patient characteristics including gender, age, race, and All Patient Refined (APR) severity of illness (SOI), and risk of mortality (ROM) were analyzed. The Primary outcome was total cost. Data was analyzed using Student t-test and univariate analysis.

Results

Between 2017 and 2021, 38,344 patients, 76.6% male, underwent CABG in New York State. Race was documented identifying 67.0% White, 7.0% Black/African American, 0.7% multiracial, and 25.4% other. The mean length of stay (LOS) was 9.9 days. The average total hospital cost was $61,596.90. The average hospital cost for Black/African Americans was $71,683.12, 19.7% ($14,119.67) more than Whites, the lowest paying racial group (13.56 P < 0.05). Black/African Americans also had the longest average LOS of 11.7 days, compared to 9.6 days for white patients, 11.3 days for multi-racial patients and 10.3 days for those who identified as other. Univariate analysis exhibited factors associated with the top quartile of hospital cost (≥$68,608) for CABG included Black/ African American race (2.01 CI 0.61−0.78), LOS more than 6 days (9.68, CI 2.18–2.35), major APR severity of illness (5.55, CI 1.15–1.91) and extreme (28.09, CI 3.13–3.54) and major (5.28, CI 1.56–1.76) and extreme APR risk of mortality (16.9, CI 2.72–2.94).

Conclusion

The cost of coronary artery bypass grafting surgery is influenced by a variety of factors including race, APR severity score, mortality risk and length of stay.