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医疗保险覆盖人群中主要住院心血管手术的收入、成本及边际贡献。

Revenues, costs, and contribution margins of major inpatient cardiovascular procedures within the Medicare population.

作者信息

Reddy Kriyana P, Shutlz Kaitlyn, Eberly Lauren A, Khatana Sameed Ahmed M, Fanaroff Alexander C, David Guy, Cohen David J, Groeneveld Peter W, Giri Jay, Nathan Ashwin S

机构信息

Penn Cardiovascular Quality, Outcomes and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA.

Penn Cardiovascular Quality, Outcomes and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.

出版信息

Am Heart J. 2025 Mar;281:43-48. doi: 10.1016/j.ahj.2024.11.013. Epub 2024 Dec 3.

Abstract

INTRODUCTION

We sought to measure the revenues, costs, and contribution margins (CMs) for major inpatient cardiovascular procedures in the Medicare population in years 2016-2019, evaluate the differences in CMs across procedures, and identify temporal trends in CMs.

METHODS

Claim-level costs were calculated using cost-to-charge ratios and subsequently Winsorized to adjust for outliers, and CMs were assessed as the difference between revenue and costs.

RESULTS AND DISCUSSION

We found that revenues, costs, and CMs vary widely across major inpatient cardiovascular procedures and that rapidly proliferating cardiovascular procedures contribute sizeable net CMs to US hospitals.

摘要

引言

我们试图衡量2016 - 2019年医疗保险人群中主要住院心血管手术的收入、成本和边际贡献(CM),评估各手术之间CM的差异,并确定CM的时间趋势。

方法

使用成本收费比计算索赔级成本,随后进行缩尾处理以调整异常值,并将CM评估为收入与成本之间的差异。

结果与讨论

我们发现,主要住院心血管手术的收入、成本和CM差异很大,并且快速增长的心血管手术为美国医院贡献了可观的净CM。

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