Cost Comparison of Elective Invasive Procedures between Elderly and Non-Elderly Patients at an Academic Medical Center

Adam M Reisman,Kevin Farrell,I Michael Leitman

doi:10.29024/jsim.9

Adam M Reisman, Kevin Farrell + Show 1 more

Open Access

https://doi.org/10.29024/jsim.9

Copy DOI

Abstract

The objective of this study was to determine whether a correlation exists between patient age and hospital expenditures for common complex elective surgical procedures. Hospital charges at an urban academic medical center were categorized by diagnosis related group (DRG) and separated into two cohorts based on patient age (≥65 years old and <65 years old). The costliest elective procedures were identified and the average total hospital cost per procedure was calculated for each group. A Student t-test was performed to compare the average cost per procedure in each cohort and a linear regression model was performed to assess whether a linear correlation existed between patient age and cost per case. Among the costliest elective procedures identified, major elective cardiovascular, spine, and intestinal procedures were costlier in patients ≥65 years. Major transplantation, vascular procedures, and joint replacement surgery were not costlier. Further, none of the identified procedures demonstrated a linear correlation between patient age and cost per case. This finding, combined with other outcome measures, may allow us to re-examine the age limits for these complex procedures.

Highlights

There is a perception that age is a cost driver for complex elective procedures
Total hospital expenditures were defined as the direct costs incurred by the hospital for all inpatient encounters associated with a particular diagnosis related group (DRG)
The associated R2 values following linear regression modeling ranged from 0.003 to 0.201 (Table 2), where R2 represented the strength of the linear relationship between patient age and cost per case [1]. This analysis has identified some of the costliest elective procedures performed at an academic medical center and determined which of those procedures are more expensive to perform on elderly patients

Summary

Objectives

The objective of this study was to determine whether a correlation exists between patient age and hospital expenditures for common complex elective surgical procedures

Methods

Results

Conclusion