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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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  • 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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    1. 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.
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    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.
    4. James Gaughan & Conrad Kobel, 2014. "Coronary artery bypass grafts and diagnosis related groups: patient classification and hospital reimbursement in 10 European countries," Health Economics Review, Springer, vol. 4(1), pages 1-13, December.

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