Impact of hospital volume and specialization on the cost of orbital trauma care

Research output: Contribution to journalArticle

Abstract

Purpose To examine the impact of hospital volume and specialization on the cost of orbital trauma care. Design Comparative case series and database study. Participants Four hundred ninety-nine patients who underwent orbital reconstruction at either a high-volume regional eye trauma center, its academic parent institution, or all other hospitals in Maryland between 2004 and 2009. Methods We used a publicly available database of hospital discharge data to identify the study population's clinical and cost characteristics. Multivariate models were developed to determine the impact of care setting on hospital costs while controlling for patient demographic and clinical variables. Main Outcome Measures Mean hospital costs accrued during hospital admission for orbital reconstruction in 3 separate care settings. Results Almost half (n = 248) of all patients received surgical care at the regional eye trauma center and had significantly lower adjusted mean hospital costs ($6194; 95% confidence interval [CI], $5709-$6719) compared with its parent institution ($8642; 95% CI, $7850-$9514) and all other hospitals ($12 692; 95% CI, $11 467-$14 047). A subpopulation analysis selecting patients with low comorbidity scores also was performed. The eye trauma center continued to have lower adjusted costs ($4277; 95% CI, $4112-$4449) relative to its parent institution ($6595; 95% CI, $5838-$7451) and other hospitals ($7150; 95% CI, $5969-$8565). Conclusions Higher volume and specialization seen at a regional eye trauma center are associated with lower costs in the surgical management of orbital trauma. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish (US)
Pages (from-to)2741-2746
Number of pages6
JournalOphthalmology
Volume120
Issue number12
DOIs
StatePublished - Dec 2013

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Trauma Centers
Confidence Intervals
Costs and Cost Analysis
Hospital Costs
Wounds and Injuries
Databases
Disclosure
Comorbidity
Demography
Outcome Assessment (Health Care)
Population

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

Cite this

Impact of hospital volume and specialization on the cost of orbital trauma care. / Koo, John J.; Wang, Jiangxia; Thompson, Carol; Merbs, Shannath L; Grant, Michael.

In: Ophthalmology, Vol. 120, No. 12, 12.2013, p. 2741-2746.

Research output: Contribution to journalArticle

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abstract = "Purpose To examine the impact of hospital volume and specialization on the cost of orbital trauma care. Design Comparative case series and database study. Participants Four hundred ninety-nine patients who underwent orbital reconstruction at either a high-volume regional eye trauma center, its academic parent institution, or all other hospitals in Maryland between 2004 and 2009. Methods We used a publicly available database of hospital discharge data to identify the study population's clinical and cost characteristics. Multivariate models were developed to determine the impact of care setting on hospital costs while controlling for patient demographic and clinical variables. Main Outcome Measures Mean hospital costs accrued during hospital admission for orbital reconstruction in 3 separate care settings. Results Almost half (n = 248) of all patients received surgical care at the regional eye trauma center and had significantly lower adjusted mean hospital costs ($6194; 95{\%} confidence interval [CI], $5709-$6719) compared with its parent institution ($8642; 95{\%} CI, $7850-$9514) and all other hospitals ($12 692; 95{\%} CI, $11 467-$14 047). A subpopulation analysis selecting patients with low comorbidity scores also was performed. The eye trauma center continued to have lower adjusted costs ($4277; 95{\%} CI, $4112-$4449) relative to its parent institution ($6595; 95{\%} CI, $5838-$7451) and other hospitals ($7150; 95{\%} CI, $5969-$8565). Conclusions Higher volume and specialization seen at a regional eye trauma center are associated with lower costs in the surgical management of orbital trauma. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.",
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