Year: 2019
Type: dissertation
Study design: Observational Study
Abstract: \nTITLE: The Correlation Between Patient Comorbidities and Bundled Payment\nExpenditures\nJordan Anderson, Anamika Chaudhuri, Timothy Ferris, Sree Chaguturu\nPurpose: Episode-based payments have been developed as an alternative payment methodology\nto reduce unnecessary healthcare spending and improve outcomes for acute episodes of care. In\nthis study we examine eleven different acute episodes of care to determine the correlation\nbetween a patient’s comorbidity burden and their total medical expenditures for a longitudinal\n90-day episode-of-care.\nMethods: Using historical claims data, patients admitted for one of the defined episodes of care\nwere assigned a clinical risk score using the Elixhauser Van-Walraven Comorbidity Index\n(EVCI). Total medical expenses were summed over a longitudinal 90-day episode of care using\nthe Medicare grouping methodology. A correlation analysis was used to assess the association\nbetween patient EVCI score and longitudinal 90-day medical expenditures.\nResults: The correlation between EVCI and episode expenditures ranged from the highest\ncorrelation for major bowel surgery (R=0.22; p < 0.0001) to the lowest correlation value for\ndouble joint replacement lower extremity (R= -0.05 ; p = 0.62). The results also showed\nvariability in the range of EVCI scores for different conditions. Congestive heart failure (EVCI:\n23.19; SD 12.25) had the highest average EVCI score indicating a high-degree of comorbidity\namongst patients. Whereas cervical spinal fusion surgery (EVCI: 7.38; SD 11.12) had the lowest\naverage EVCI score.\nConclusions: The correlation between patient EVCI score and longitudinal 90-day expenditures\nvaried across different acute episodes of care, but were found to demonstrate an overall weak\ncorrelation.
Author: J.D. Anderson
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2993698972