Thakore Rachel V, Lee Young M, Sathiyakumar Vasanth, Obremskey William T, Sethi Manish K
The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Suite 4200, South Tower, MCE, Nashville, TN 37221, USA.
Curr Gerontol Geriatr Res. 2014;2014:923717. doi: 10.1155/2014/923717. Epub 2014 Apr 30.
Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status.
目的。确定美国麻醉医师协会(ASA)评分是否可用于预测住院服务的医院费用。材料与方法。在一家一级创伤中心对547名60岁以上因髋部骨折前来就诊并需要手术固定的患者进行了回顾性病历审查。与住院和术后服务相关的医院费用被整理为六类护理项目。进行方差分析和线性回归模型,以比较术前ASA评分与费用及住院服务情况。结果。住院和术后费用及服务与患者的ASA评分显著相关。ASA评分为4的患者平均住院服务费用最高,为15,555美元,而ASA评分为2的患者为10,923美元。ASA评分为4的患者平均有45.3项医院服务,而评分为2的患者为24.1项。结论。患者的ASA评分与住院服务的总费用和特定费用相关。本研究结果将使支付方能够根据髋部骨折患者的术前身体状况确定住院服务的主要成本驱动因素。