18: Geographic variation of hospital costs and volume of female pelvic reconstructive procedures

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Studies have shown that there are vast differences in cost of care for the same type of procedure due to geographic differences in medical practice across the United States. The goal of this study is to evaluate how cost and volume of cases differ by the geographic region where female pelvic reconstructive procedures are performed. We used the 2016 Medicare Inpatient Utilization and Payment Data. This database includes information on utilization, payment, hospital-specific charges for U.S. hospitals across the country that receive Medicare payments. We used data aggregated at the state level and regional level. Diagnosis Related Group (DRG) codes were used to identify hospital charges for patients who underwent female pelvic reconstructive procedures and were admitted inpatient. The total inpatient hospital charges were converted to total cost using the Medicare cost-to-charge ratios for each state. A total of 2,133 inpatients carrying the diagnosis of female pelvic reconstructive procedures were identified. The Northeast region had the lowest average cost ($10,888) and the West region was associated with the highest average cost ($13,766) (Table 1). Two states, Missouri and Virginia, are outliers in the average hospital costs for female pelvic reconstructive procedures (both >$20,000) compared to the median cost ($11,473) (Figure 1). Several states, Kansas, Mississippi, and Oklahoma are outliers in the volume of procedures performed per 100,000 Medicare beneficiaries (>9 compared to median of 4.06 procedures per 100,000 Medicare beneficiaries). The cost of inpatient care for female pelvic reconstructive surgeries differs across geographic region within the U.S. There are several outlier states with much higher average cost per patient or higher volume of inpatient admissions following these surgeries adjusted for size of Medicare population.View Large Image Figure ViewerDownload Hi-res image Download (PPT)