Newton Ashley N, Ewer Sid R
University of Oklahoma, Division of Finance, USA.
J Health Care Finance. 2010 Winter;37(2):56-80.
This study uses longitudinal data of inpatient treatment from the Agency for Healthcare Research and Quality's (AHRQ's) Healthcare Cost and Utilization Project (HCUP) to examine the differences in historical trends and build future projections of charges, costs, and lengths of stay (LOS) for inpatient treatment of four of the most prevalent cancer types: breast, colon, lung, and prostate. We stratify our data by hospital ownership type and for the aforementioned four major cancer types. We use the Kruskal Wallis (nonparametric ANOVA) Test and time series models to analyze variance and build projections, respectively, for mean charges per discharge, mean costs per discharge, mean LOS per discharge, mean charges per day, and mean costs per day. We find that significant differences exist in both the mean charges per discharge and mean charges per day for breast, colon, lung, and prostate cancers and in the mean LOS per discharge for breast cancer. Additionally, we find that both mean charges and mean costs are forecast to continue increasing while mean LOS are forecast to continue decreasing over the forecast period 2008 to 2012. The methodologies we employ may be used by individual hospital systems, and by health care policy-makers, for various financial planning purposes. Future studies could examine additional financial and nonfinancial variables for these and other cancer types, test for geographic disparities, or focus on procedural-level hospital measures.
本研究使用美国医疗保健研究与质量局(AHRQ)的医疗成本与利用项目(HCUP)中的住院治疗纵向数据,来检验四种最常见癌症类型(乳腺癌、结肠癌、肺癌和前列腺癌)住院治疗费用、成本及住院时长(LOS)的历史趋势差异,并进行未来预测。我们按医院所有制类型以及上述四种主要癌症类型对数据进行分层。我们分别使用Kruskal Wallis(非参数方差分析)检验和时间序列模型来分析方差,并对每次出院的平均费用、每次出院的平均成本、每次出院的平均住院时长、每日平均费用和每日平均成本进行预测。我们发现,乳腺癌、结肠癌、肺癌和前列腺癌的每次出院平均费用和每日平均费用以及乳腺癌的每次出院平均住院时长均存在显著差异。此外,我们发现,在2008年至2012年的预测期内,预计平均费用和平均成本将持续上升,而平均住院时长将持续下降。我们采用的方法可被各医院系统以及医疗保健政策制定者用于各种财务规划目的。未来的研究可以针对这些及其他癌症类型研究更多的财务和非财务变量,检验地理差异,或关注医院层面的程序指标。