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Why Do Patients Having Coronary Artery Bypass Grafts Have Different Costs Or Length Of Stay? An Analysis Across 10 European Countries

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Listed:
  • James Gaughan
  • Conrad Kobel
  • Caroline Linhart
  • Anne Mason
  • Andrew Street
  • Padraic Ward
  • on behalf of the EuroDRG group

Abstract

We analyse variations in cost or length of stay (LoS) for 66 587 patients from 10 European countries receiving a coronary artery bypass graft (CABG) procedure. In five of these countries, variations in cost are analysed using log‐linear models. In the other five countries, negative binomial regression models are used to explore variations in LoS. We compare how well each country's diagnosis‐related group (DRG) system and a set of patient‐level characteristics explain these variations. The most important explanatory factors are the total number of diagnoses and procedures, although no clear effects are evident for our CABG‐specific diagnostic and procedural variables. Wound infections significantly increase LoS and costs in most countries. There is no evidence that countries using larger numbers of DRGs to group CABG patients are better at explaining variations in cost or LoS. However, refinements to the construction of DRGs to group CABG patients might recognise first and subsequent CABGs or other specific surgical procedures, such as multiple valve repair. Copyright © 2012 John Wiley & Sons, Ltd.

Suggested Citation

  • James Gaughan & Conrad Kobel & Caroline Linhart & Anne Mason & Andrew Street & Padraic Ward & on behalf of the EuroDRG group, 2012. "Why Do Patients Having Coronary Artery Bypass Grafts Have Different Costs Or Length Of Stay? An Analysis Across 10 European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 77-88, August.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:s2:p:77-88
    DOI: 10.1002/hec.2842
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    References listed on IDEAS

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    1. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    2. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    3. Conrad Kobel & Josselin Thuilliez & Martine Bellanger & Karl-Peter Pfeiffer, 2011. "DRG systems and similar patient classification systems in Europe," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00643049, HAL.
    4. Brigitte Dormont & Carine Milcent, 2005. "How to Regulate Heterogeneous Hospitals?," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 14(3), pages 591-621, September.
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    6. repec:dau:papers:123456789/5425 is not listed on IDEAS
    7. Saskia Drösler & Patrick Romano & Lihan Wei, 2009. "Health Care Quality Indicators Project: Patient Safety Indicators Report 2009," OECD Health Working Papers 47, OECD Publishing.
    8. Robert B. Fetter, 1991. "Diagnosis Related Groups: Understanding Hospital Performance," Interfaces, INFORMS, vol. 21(1), pages 6-26, February.
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    10. Brigitte Dormont & Carine Milcent, 2005. "How to Regulate Heterogeneous Hospitals?," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 14(3), pages 591-621, September.
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    1. Marcello Montefiori & Michela Pasquarella & Paolo Petralia, 2020. "The effectiveness of the neonatal diagnosis-related group scheme," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-12, August.
    2. Reinhard Busse & on behalf of the EuroDRG group, 2012. "DO DIAGNOSIS‐RELATED GROUPS EXPLAIN VARIATIONS IN HOSPITAL COSTS AND LENGTH OF STAY? – ANALYSES FROM THE EURODRG PROJECT FOR 10 EPISODES OF CARE ACROSS 10 EuroPEAN COUNTRIES," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 1-5, August.
    3. James Gaughan & Anne Mason & Andrew Street & Padraic Ward, 2012. "English Hospitals Can Improve Their Use of Resources: An Analysis of Costs and Length of Stay for Ten Treatments," Working Papers 078cherp, Centre for Health Economics, University of York.

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