Article

The aim of this study was to identify patient- and facility-level
factors associated with total inpatient costs and length of stay (LOS) among
veterans who underwent lower extremity amputation. DESIGN: Patient data for 1536
veterans were compiled from nine databases from the Veterans Health
Administration between October 1, 2002, and September 30, 2003. Linear mixed
models were used to identify the factors associated with the natural logarithm of
total inpatient costs and LOS. RESULTS: Statistically significant factors
associated with both higher total inpatient costs and longer LOS included
admission by transfer from another hospital, systemic sepsis, arrhythmias,
chronic blood loss anemia, fluid and electrolyte disorders, weight loss,
specialized inpatient rehabilitation, and higher hospital bed counts. Device
infection, coagulopathy, solid tumor without metastasis, Commission on
Accreditation of Rehabilitation Facilities accreditation, and the Medicare Wage
Index were associated with only higher total inpatient costs. The factors
associated with only longer LOS included older age, not being married, previous
amputation complication, congestive heart failure, deficiency anemias, and
paralysis. CONCLUSIONS: Most drivers of total inpatient costs were similar to
those that increased LOS, with a few exceptions. These findings may have
implications for projecting future healthcare costs and thus could be important
in efforts to reducing costs, understanding LOS, and refining payment and
budgeting policies.

Langue : ANGLAIS