Estimating the cost of care for emergency department syncope patients: Comparison of three models

Marc A. Probst, Kenneth (John) McConnell, Robert E. Weiss, Amber L. Laurie, Annick N. Yagapen, Michelle P. Lin, Jeffrey M. Caterino, Manish N. Shah, Benjamin Sun

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: We sought to compare three hospital cost-estimation models for patients undergoing evaluation for unexplained syncope using hospital cost data. Developing such a model would allow researchers to assess the value of novel clinical algorithms for syncope management. Methods: We collected complete health services data, including disposition, testing, and length of stay (LOS), on 67 adult patients (age 60 years and older) wh o presented to the emergency department (ED) with syncope at a single hospital. Patients were excluded if a serious medical condition was identified. We created three hospital cost-estimation models to estimate fac ility costs: V1, unadjusted Medicare payments for observation and/or hospital admission; V2: modified Medicare payment, prorated by LOS in calendar days; and V3: modified Medicare payment, prorated by LOS in hours. Total hospital costs included unadjusted Medicare payments for diagnostic testing and estimated facility costs. We plotted these estimates against actual cost data from the hospital finance department, and performed correla tion and regression analyses. Results: Of the three models, V3 consistently outperformed the others with regard to correlation and goodness of fit. The Pearson correlation coefficient for V3 was 0.88 (95% confiden ce interval [CI] 0.81, 0.92) with an R-square value of 0.77 and a linear regression coefficient of 0.87 (95% CI 0.76, 0.99). Conclusion: Using basic health services data, it is possible to accurately estimate hospital costs for older adults undergoing a hospital-based evaluation f or unexplained syncope. This methodology could help assess the potential economic impact of implementing novel clinical algorithms for ED syncope.

Original languageEnglish (US)
Pages (from-to)253-257
Number of pages5
JournalWestern Journal of Emergency Medicine
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2017

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Hospital Costs
Syncope
Hospital Emergency Service
Medicare
Costs and Cost Analysis
Length of Stay
Health Services
Hospital Departments
Linear Models
Regression Analysis
Economics
Research Personnel
Observation

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Estimating the cost of care for emergency department syncope patients : Comparison of three models. / Probst, Marc A.; McConnell, Kenneth (John); Weiss, Robert E.; Laurie, Amber L.; Yagapen, Annick N.; Lin, Michelle P.; Caterino, Jeffrey M.; Shah, Manish N.; Sun, Benjamin.

In: Western Journal of Emergency Medicine, Vol. 18, No. 2, 01.02.2017, p. 253-257.

Research output: Contribution to journalArticle

Probst, Marc A. ; McConnell, Kenneth (John) ; Weiss, Robert E. ; Laurie, Amber L. ; Yagapen, Annick N. ; Lin, Michelle P. ; Caterino, Jeffrey M. ; Shah, Manish N. ; Sun, Benjamin. / Estimating the cost of care for emergency department syncope patients : Comparison of three models. In: Western Journal of Emergency Medicine. 2017 ; Vol. 18, No. 2. pp. 253-257.
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