IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v12y2003i11p935-947.html
   My bibliography  Save this article

Estimating mean hospital cost as a function of length of stay and patient characteristics

Author

Listed:
  • Elena Polverejan
  • Joseph C. Gardiner
  • Cathy J. Bradley
  • Margaret Holmes‐Rovner
  • David Rovner

Abstract

Statistical models have been used to assess the influence of clinical and demographic factors on hospital charge and length of stay (LOS). Hospital costs constitute a significant proportion of overall expenditure in health care. With escalating costs, knowing the correlates of LOS and in‐hospital cost is important for decisions on allocating resources. However, hospital charge and LOS are correlated. We describe two regression models that permit estimation of mean charges as a function of patient hospital stay and adjust for the influence of patient characteristics and treatment procedures on LOS and charge. In the first model, the mean charge over a specified duration is a weighted average of the expected cumulative charge, with weighting determined by the distribution of LOS. The second model for LOS and charge explicitly accounts for their correlation and yields estimates of the average charge per average LOS. The methods are applied to assess mean charges and mean charge per day by cardiac procedure in a cohort of patients hospitalized for acute myocardial infarction, while adjusting for the impact of patient demographic and clinical factors on LOS and charge. For relatively short hospital stays, and when only total hospital charges are available, these models provide a flexible approach to estimating summary measures on resource use while controlling for the effects of covariates on LOS and charge. Copyright © 2002 John Wiley & Sons, Ltd.

Suggested Citation

  • Elena Polverejan & Joseph C. Gardiner & Cathy J. Bradley & Margaret Holmes‐Rovner & David Rovner, 2003. "Estimating mean hospital cost as a function of length of stay and patient characteristics," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 935-947, November.
    • Handle: RePEc:wly:hlthec:v:12:y:2003:i:11:p:935-947
    DOI: 10.1002/hec.774
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.774
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.774?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Etzioni, Ruth D. & Feuer, Eric J. & Sullivan, Sean D. & Lin, Danyu & Hu, Chengcheng & Ramsey, Scott D., 1999. "On the use of survival analysis techniques to estimate medical care costs," Journal of Health Economics, Elsevier, vol. 18(3), pages 365-380, June.
    2. D. Y. Lin, 2000. "Proportional Means Regression for Censored Medical Costs," Biometrics, The International Biometric Society, vol. 56(3), pages 775-778, September.
    3. Joseph Gardiner & Andrew Hogan & Margaret Holmes-Rovner & David Rovner & Lawrence Griffith & Joel Kupersmith, 1995. "Confidence Intervals for Cost - Effectiveness Ratios," Medical Decision Making, , vol. 15(3), pages 254-263, August.
    4. Ai, Chunrong & Norton, Edward C., 2000. "Standard errors for the retransformation problem with heteroscedasticity," Journal of Health Economics, Elsevier, vol. 19(5), pages 697-718, September.
    5. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Donald J Wright, 2004. "Specialist payment schemes and patient selection in private and public hospitals, CHERE Discussion Paper No 54," Discussion Papers 54, CHERE, University of Technology, Sydney.
    2. Emi Sato & Kiyohide Fushimi, 2009. "What has influenced patient health‐care expenditures in Japan?: variables of age, death, length of stay, and medical care," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 843-853, July.
    3. Anne Mason & Zeynep Or & Thomas Renaud & Andrew Street & Josselin Thuilliez & Padraic Ward & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups For Appendectomy Explain Variations In Resource Use? An Analysis Of Patient‐Level Data From 10 European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 30-40, August.
    4. Unto Häkkinen & Pietro Chiarello & Francesc Cots & Mikko Peltola & Hanna Rättö & ON BEHALF OF THE EURODRG GROUP, 2012. "Patient Classification And Hospital Costs Of Care For Acute Myocardial Infarction In Nine European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 19-29, August.
    5. Zhao, Xiaobing & Zhou, Xian, 2012. "Estimation of medical costs by copula models with dynamic change of health status," Insurance: Mathematics and Economics, Elsevier, vol. 51(2), pages 480-491.
    6. Xiao Zhao & Xian Zhou, 2015. "Estimation of copula-based models for lifetime medical costs," Annals of the Institute of Statistical Mathematics, Springer;The Institute of Statistical Mathematics, vol. 67(5), pages 897-915, October.
    7. Wright, Donald J., 2007. "Specialist payment schemes and patient selection in private and public hospitals," Journal of Health Economics, Elsevier, vol. 26(5), pages 1014-1026, September.
    8. Kuwabara, Hiroyo & Fushimi, Kiyohide, 2009. "The impact of a new payment system with case-mix measurement on hospital practices for breast cancer patients in Japan," Health Policy, Elsevier, vol. 92(1), pages 65-72, September.
    9. Malgorzata Cyganska & Piotr Cyganski & Chris Pyke, 2019. "Development of clinical value unit method for calculating patient costs," Health Economics, John Wiley & Sons, Ltd., vol. 28(8), pages 971-983, August.
    10. Jason Sutherland & Colin Preyra, 2006. "A mixture model approach to updating payment weights with an application to ICD-10 implementation," Health Care Management Science, Springer, vol. 9(4), pages 349-357, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Y. T. Hwang & C. H. Huang & W. L. Yeh & Y. D. Shen, 2017. "The weighted general linear model for longitudinal medical cost data – an application in colorectal cancer," Journal of Applied Statistics, Taylor & Francis Journals, vol. 44(2), pages 288-307, January.
    2. Hao Yu, 2017. "China’s medical savings accounts: an analysis of the price elasticity of demand for health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 773-785, July.
    3. Liu, Lei & Conaway, Mark R. & Knaus, William A. & Bergin, James D., 2008. "A random effects four-part model, with application to correlated medical costs," Computational Statistics & Data Analysis, Elsevier, vol. 52(9), pages 4458-4473, May.
    4. Zhao, Xiaobing & Zhou, Xian, 2012. "Estimation of medical costs by copula models with dynamic change of health status," Insurance: Mathematics and Economics, Elsevier, vol. 51(2), pages 480-491.
    5. Jones, A.M, 2010. "Models For Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 10/01, HEDG, c/o Department of Economics, University of York.
    6. Amir Marashi & Shima Ghassem Pour & Vincy Li & Chris Rissel & Federico Girosi, 2019. "The association between physical activity and hospital payments for acute admissions in the Australian population aged 45 and over," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-16, June.
    7. Yves Staudt & Joël Wagner, 2021. "Assessing the Performance of Random Forests for Modeling Claim Severity in Collision Car Insurance," Risks, MDPI, vol. 9(3), pages 1-28, March.
    8. Basu A & Manning WG, 2009. "Estimating Lifetime or Episode-of-illness Costs," Health, Econometrics and Data Group (HEDG) Working Papers 09/12, HEDG, c/o Department of Economics, University of York.
    9. Borislava Mihaylova & Andrew Briggs & Anthony O'Hagan & Simon G. Thompson, 2011. "Review of statistical methods for analysing healthcare resources and costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 897-916, August.
    10. Ileana Baldi & Eva Pagano & Paola Berchialla & Alessandro Desideri & Alberto Ferrando & Franco Merletti & Dario Gregori, 2013. "Modeling healthcare costs in simultaneous presence of asymmetry, heteroscedasticity and correlation," Journal of Applied Statistics, Taylor & Francis Journals, vol. 40(2), pages 298-310, February.
    11. Gospodinov, Nikolay & Irvine, Ian, 2009. "Tobacco taxes and regressivity," Journal of Health Economics, Elsevier, vol. 28(2), pages 375-384, March.
    12. Nicholas Hill & Richard McGregory & James Peoples, 2018. "Noncitizen Employment and the Wages of Healthcare Support Workers in the US," Journal of Labor Research, Springer, vol. 39(4), pages 433-461, December.
    13. Samuel Sebsibie & Workineh Asmare & Tessema Endalkachew, 2015. "Agricultural Technology Adoption and Rural Poverty: a Study on Smallholders in Amhara Regional State, Ethiopia," Ethiopian Journal of Economics, Ethiopian Economics Association, vol. 23(2), December.
    14. Thorvaldur Gylfason & Inmaculada Martínez-Zarzoso & Per Magnus Wijkman, 2015. "Free Trade Agreements, Institutions and the Exports of Eastern Partnership Countries," Journal of Common Market Studies, Wiley Blackwell, vol. 53(6), pages 1214-1229, November.
    15. Patrick Richard & Regine Walker & Pierre Alexandre, 2018. "The burden of out of pocket costs and medical debt faced by households with chronic health conditions in the United States," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-13, June.
    16. Trottmann, Maria & Zweifel, Peter & Beck, Konstantin, 2012. "Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?," Journal of Health Economics, Elsevier, vol. 31(1), pages 231-242.
    17. Schaak, Henning, 2015. "The Impact of Free Trade Agreements on International Agricultural Trade: A Gravity Application on the Dairy Product Trade and the ASEAN-China-FTA," 55th Annual Conference, Giessen, Germany, September 23-25, 2015 211619, German Association of Agricultural Economists (GEWISOLA).
    18. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
    19. Anand Acharya & Lynda Khalaf & Marcel Voia & Myra Yazbeck & David Wensley, 2021. "Severity of Illness and the Duration of Intensive Care," Working Papers 2021-003, Human Capital and Economic Opportunity Working Group.
    20. Judite Gonçalves & France Weaver, 2017. "Effects of formal home care on hospitalizations and doctor visits," International Journal of Health Economics and Management, Springer, vol. 17(2), pages 203-233, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:12:y:2003:i:11:p:935-947. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.