患者特征对冠状动脉搭桥术患者住院总费用的影响

Q3 Medicine

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI:10.1016/j.jemep.2025.101072

J. Katsiroubas , J. Wong , K. Jonnalagadda , T.S. Guy

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引用次数: 0

摘要

冠状动脉旁路移植术（CABG）是美国最常见的手术之一，平均费用约为4万美元。然而，这些费用的负担在不同人口群体的患者中可能不平等。本研究的目的是表征冠状动脉搭桥手术后总成本增加的相关因素。方法查询2017-2021年全州规划与研究合作系统（SPARCS）数据库，以确定纽约州接受CABG的患者。分析患者特征，包括性别、年龄、种族、所有患者精炼（APR）疾病严重程度（SOI）和死亡风险（ROM）。主要结果是总成本。数据分析采用学生t检验和单变量分析。结果2017年至2021年期间，纽约州有38,344例患者（76.6%为男性）接受了CABG。种族被记录为67.0%白人，7.0%黑人/非裔美国人，0.7%多种族，25.4%其他。平均住院时间（LOS）为9.9天。平均总住院费用为61 596.90美元。黑人/非裔美国人的平均住院费用为71,683.12美元，比白人(13.56 P <；0.05)。黑人/非裔美国人的平均死亡时间最长，为11.7天，而白人患者为9.6天，多种族患者为11.3天，其他种族患者为10.3天。单因素分析显示，与CABG住院费用（≥68,608美元）最高四分位数相关的因素包括黑人/非裔美国人种族（2.01 CI 0.61−0.78）、LOS超过6天（9.68,CI 2.18—2.35）、APR严重程度（5.55,CI 1.15—1.91）和APR严重死亡风险（28.09,CI 3.13—3.54）和APR严重死亡风险（5.28,CI 1.56—1.76）（16.9,CI 2.72—2.94）。结论冠状动脉搭桥术费用受种族、APR严重程度评分、死亡风险和住院时间等多种因素影响。

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

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.

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来源期刊

Ethics, Medicine and Public Health Medicine-Health Policy

CiteScore

2.20

自引率

0.00%

发文量

107

审稿时长

42 days

期刊介绍： This review aims to compare approaches to medical ethics and bioethics in two forms, Anglo-Saxon (Ethics, Medicine and Public Health) and French (Ethique, Médecine et Politiques Publiques). Thus, in their native languages, the authors will present research on the legitimacy of the practice and appreciation of the consequences of acts towards patients as compared to the limits acceptable by the community, as illustrated by the democratic debate.