Thomas E H, Fox D M
Health Matrix. 1988 Summer;6(2):15-49.
From hospital accounting data on 402 patients, this study calculated annual, lifetime and perdiem cost, assessed the relationship to cost risk group, diagnosis, payer, and DRG, and estimated how the cost burden was shared between hospitals and third-party payers. Conclusions were as follows: Annual impatient hospital cost for adults with AIDS averaged +22,300, incurred during an average of 38 hospital days. Lifetime inpatient hospital costs averaged +38,200, incurred during an average of 62 hospital days. Patients with AIDS did not make more intensive use of hospital ancillary services than the average medical/surgical patient. They incurred exceptional per diem costs for laboratory and pharmacy services, but this was offset by lower operating room costs. Cost did not bear a statistically significant relationship to risk group in adult patients, but hospital utilization, and thus annual cost, ws very different for pediatric patients. There was limited evidence of a relationship between cost and diagnosis and between cost and payer. Eighty-two percent of the total cost was reimbursed by third-party payers: Medicaid (28 percent), Blue Cross (26 percent), Medicare (3 percent) and commercial insurance and other payers (25 percent). We estimate that self-pay patients paid 13 percent of the cost, and that 5 percent was unreimbursed.
本研究依据402名患者的医院会计数据,计算了年度、终生及每日成本,评估了其与成本风险组、诊断、付款方及诊断相关分组(DRG)的关系,并估算了医院与第三方付款方之间成本负担的分担情况。研究结论如下:成年艾滋病患者的年度住院费用平均为22,300美元,平均住院天数为38天。终生住院费用平均为38,200美元,平均住院天数为62天。艾滋病患者对医院辅助服务的使用强度并不高于普通内科/外科患者。他们在实验室和药房服务方面每日花费较高,但手术室费用较低,两相抵消。成年患者的成本与风险组之间无统计学显著关系,但儿科患者的医院利用率及年度成本差异很大。成本与诊断以及成本与付款方之间的关系证据有限。总成本的82%由第三方付款方报销:医疗补助(28%)、蓝十字(26%)、医疗保险(3%)以及商业保险和其他付款方(25%)。我们估计自费患者支付了13%的成本,5%未得到报销。