HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Williams, T. E. Articles by Blom, D. P. Search for Related Content PubMed PubMed Citation Articles by Williams, T. E., Jr Articles by Blom, D. P.

The Annals of Thoracic Surgery, Vol 58, 815-820, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Can we afford to do cardiac operations in 1996? A risk-reward curve for cardiac surgery

TE Williams Jr, WJ Fanning, L Link, WC Benton, GS Kakos, RL Miller, TD Hankins and DP Blom
Division of Thoracic and Cardiovascular Surgery, Ohio State University, Columbus.

Parsonnet risk estimates and postoperative lengths of stay were studied for two cohorts of cardiac surgical patients. The first cohort consisted of 287 patients and was taken from 1984, the first full year of this cardiac surgical program. The second cohort consisted of all 1,167 patients operated on in the calendar years 1989 to 1991. We found that the mean risk for the patients had nearly doubled in this interval and that the risk distribution changed significantly from one skewed toward good-risk patients to a nearly uniform distribution through all risk categories. A high correlation was identified (0.9761) between the postoperative length of stay and the mean risk estimates for the 1989 to 1991 cohort of patients. This permits a regression equation to be calculated showing that the length of stay could be estimated at 7.06 days + 0.21 times the mean risk for a patient or cohort of patients. This relationship is then used to develop a relationship between the net income for a given case or cohort of patients and the length of stay or risk. These data suggest that, in most hospitals, hospital fixed costs are a major determinant, even more so than daily charges, of the relationship between the hospital's finances and the mean risks of patients undertaken in the cardiac surgical program. The consequences of this are discussed.

This article has been cited by other articles:

				P. B. Jacklin, S. F. Barrington, J. C. Roxburgh, G. Jackson, D. Sariklis, P. A. West, and M. N. Maisey Cost-effectiveness of preoperative positron emission tomography in ischemic heart disease Ann. Thorac. Surg., May 1, 2002; 73(5): 1403 - 1409. [Abstract] [Full Text] [PDF]

				L. V. Doering, F. Esmailian, and H. Laks Perioperative Predictors of ICU and Hospital Costs in Coronary Artery Bypass Graft Surgery Chest, September 1, 2000; 118(3): 736 - 743. [Abstract] [Full Text] [PDF]

				C. J. Riordan, M. Engoren, A. Zacharias, T. A. Schwann, G. L. Parenteau, S. J. Durham, and R. H. Habib Resource utilization in coronary artery bypass operation: does surgical risk predict cost? Ann. Thorac. Surg., April 1, 2000; 69(4): 1092 - 1097. [Abstract] [Full Text] [PDF]

				R. Ascione, C. T. Lloyd, M. J. Underwood, A. A. Lotto, A. A. Pitsis, and G. D. Angelini Economic outcome of off-pump coronary artery bypass surgery: a prospective randomized study Ann. Thorac. Surg., December 1, 1999; 68(6): 2237 - 2242. [Abstract] [Full Text] [PDF]

				T. E. Williams Jr, W. J. Fanning, W.C. Benton, G. S. Kakos, R. L. Miller, W. J. Esterline, and T. D. Hankins What is the marginal cost for marginal risk in cardiac surgery? Ann. Thorac. Surg., December 1, 1998; 66(6): 1969 - 1971. [Abstract] [Full Text] [PDF]

				M. Zenati, MD, H. A. Cohen, MD, R. Holubkov, PhD, A. J. Conrad Smith, MD, A. J. Boujoukos, MD, J. Caldwell, MD, L. Firestone, MD, and B. P. Griffith, MD PREOPERATIVE RISK MODELS FOR MINIMALLY INVASIVE CORONARY BYPASS: A PRELIMINARY STUDY J. Thorac. Cardiovasc. Surg., October 1, 1998; 116(4): 584 - 589. [Abstract] [Full Text] [PDF]

				G. A Ortolano Potential for reduction in morbidity and cost with total leucocyte control for cardiac surgery Perfusion, September 1, 1995; 10(5): 283 - 290. [Abstract] [PDF]

				N. M. Katz, R. L. Hannan, R. A. Hopkins, and R. B. Wallace Cardiac Operations in Patients Aged 70 Years and Over: Mortality, Length of Stay, and Hospital Charge Ann. Thorac. Surg., July 1, 1995; 60(1): 96 - 100. [Abstract] [Full Text]