COMBINING INSTITUTIONAL AND ADMINISTRATIVE DATA TO ASSESS HOSPITAL COSTS FOR PATIENTS RECEIVING VENTRICULAR ASSIST DEVICES

Prichard, R; Kershaw, L; Davidson, PM; Newton, PJ; Goodall, S; Hayward, C

COMBINING INSTITUTIONAL AND ADMINISTRATIVE DATA TO ASSESS HOSPITAL COSTS FOR PATIENTS RECEIVING VENTRICULAR ASSIST DEVICES

Prichard, R

Kershaw, L Davidson, PM

Newton, PJ

Goodall, S

Hayward, C

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Publication Type:: Journal Article
Citation:: International Journal of Technology Assessment in Health Care, 2018, 34 (6), pp. 555 - 566
Issue Date:: 2018-01-01

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Field	Value	Language
dc.contributor.author	Prichard, R https://orcid.org/0000-0001-8057-6605	en_US
dc.contributor.author	Kershaw, L	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Newton, PJ https://orcid.org/0000-0002-5006-2037	en_US
dc.contributor.author	Goodall, S https://orcid.org/0000-0001-6611-6565	en_US
dc.contributor.author	Hayward, C	en_US
dc.date.issued	2018-01-01	en_US
dc.identifier.citation	International Journal of Technology Assessment in Health Care, 2018, 34 (6), pp. 555 - 566	en_US
dc.identifier.issn	0266-4623	en_US
dc.identifier.uri	http://hdl.handle.net/10453/131298
dc.description.abstract	© 2018 Cambridge University Press. Objectives: The aim of this study was to describe patient level costing methods and develop a database of healthcare resource use and cost in patients with AHF receiving ventricular assist device (VAD) therapy. Methods: Patient level micro-costing was used to identify documented activity in the years preceding and following VAD implantation, and preceding heart transplant for a cohort of seventy-seven consecutive patients listed for heart transplantation (2009-12). Clinician interviews verified activity, established time resource required for each activity, and added additional undocumented activities. Costs were sourced from the general ledger, salary, stock price, pharmacy formulary data, and from national medical benefits and prostheses lists. Linked administrative data analyses of activity external to the implanting institution, used National Weighted Activity Units (NWAU), 2014 efficient price, and admission complexity cost weights and were compared with micro-costed data for the implanting admission. Results: The database produced includes patient level activity and costs associated with the seventy-seven patients across thirteen resource areas including hospital activity external to the implanting center. The median cost of the implanting admission using linked administrative data was $246,839 (interquartile range [IQR] $246,839-$271,743), versus $270,716 (IQR $211,740-$378,482) for the institutional micro-costing (p =.08).Conclusions: Linked administrative data provides a useful alternative for imputing costs external to the implanting center, and combined with institutional data can illuminate both the pathways to transplant referral and the hospital activity generated by patients experiencing the terminal phases of heart failure in the year before transplant, cf-VAD implant, or death.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/APP1133337
dc.relation.ispartof	International Journal of Technology Assessment in Health Care	en_US
dc.relation.isbasedon	10.1017/S0266462318003586	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Hospitalization	en_US
dc.subject.mesh	Heart-Assist Devices	en_US
dc.subject.mesh	Hospital Administration	en_US
dc.subject.mesh	Databases, Factual	en_US
dc.subject.mesh	Costs and Cost Analysis	en_US
dc.subject.mesh	Hospital Costs	en_US
dc.subject.mesh	Heart Failure	en_US
dc.title	COMBINING INSTITUTIONAL AND ADMINISTRATIVE DATA TO ASSESS HOSPITAL COSTS FOR PATIENTS RECEIVING VENTRICULAR ASSIST DEVICES	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	34	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1402 Applied Economics	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	34	en_US

Abstract:

© 2018 Cambridge University Press. Objectives: The aim of this study was to describe patient level costing methods and develop a database of healthcare resource use and cost in patients with AHF receiving ventricular assist device (VAD) therapy. Methods: Patient level micro-costing was used to identify documented activity in the years preceding and following VAD implantation, and preceding heart transplant for a cohort of seventy-seven consecutive patients listed for heart transplantation (2009-12). Clinician interviews verified activity, established time resource required for each activity, and added additional undocumented activities. Costs were sourced from the general ledger, salary, stock price, pharmacy formulary data, and from national medical benefits and prostheses lists. Linked administrative data analyses of activity external to the implanting institution, used National Weighted Activity Units (NWAU), 2014 efficient price, and admission complexity cost weights and were compared with micro-costed data for the implanting admission. Results: The database produced includes patient level activity and costs associated with the seventy-seven patients across thirteen resource areas including hospital activity external to the implanting center. The median cost of the implanting admission using linked administrative data was $246,839 (interquartile range [IQR] $246,839-$271,743), versus $270,716 (IQR $211,740-$378,482) for the institutional micro-costing (p =.08).Conclusions: Linked administrative data provides a useful alternative for imputing costs external to the implanting center, and combined with institutional data can illuminate both the pathways to transplant referral and the hospital activity generated by patients experiencing the terminal phases of heart failure in the year before transplant, cf-VAD implant, or death.

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http://hdl.handle.net/10453/131298