Primary payer status, individual patient characteristics, and hospital-level factors affecting length of stay and total cost of hospitalization in total laryngectomy

Vikas Mehta, José M. Flores, Richard Will Thompson, Cherie Ann Nathan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Medicaid and uninsured patients anecdotally incur higher cost and length of stay because of nonmedical, discharge-related factors. The purpose of this study was to investigate the association between primary payer and length of stay and cost, controlling for comorbidities and complications, in patients undergoing total laryngectomy. Methods: The sample included 4128 patients who underwent total laryngectomy in the 2005 to 2010 National Inpatient Sample (NIS). Patients were categorized into 4 subgroups based on payer status: Medicare, Medicaid, uninsured, and private insurance. Using multilevel modeling, we examined differences in length of stay and hospitalization costs. Results: The odds of being in the top quartile of length of stay increased for Medicaid patients by 41% (odds ratio [OR] = 1.41; 95% confidence interval [CI] = 1.03–1.92) compared with privately insured patients. Conclusion: After controlling for medical factors, Medicaid patients had increased lengths of stay. Overall costs were highest for those with public insurance, but no difference was seen for the adjusted cost.

Original languageEnglish (US)
Pages (from-to)311-319
Number of pages9
JournalHead and Neck
Volume39
Issue number2
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

Fingerprint

Laryngectomy
Length of Stay
Hospitalization
Costs and Cost Analysis
Medicaid
Insurance
Medicare
Comorbidity
Inpatients
Odds Ratio
Confidence Intervals

Keywords

  • bundled payments
  • hospital costs
  • laryngectomy
  • length of stay
  • Medicaid

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Primary payer status, individual patient characteristics, and hospital-level factors affecting length of stay and total cost of hospitalization in total laryngectomy. / Mehta, Vikas; Flores, José M.; Thompson, Richard Will; Nathan, Cherie Ann.

In: Head and Neck, Vol. 39, No. 2, 01.02.2017, p. 311-319.

Research output: Contribution to journalArticle

@article{a7c1a0d907e94ce0ab44a16960f41da2,
title = "Primary payer status, individual patient characteristics, and hospital-level factors affecting length of stay and total cost of hospitalization in total laryngectomy",
abstract = "Background: Medicaid and uninsured patients anecdotally incur higher cost and length of stay because of nonmedical, discharge-related factors. The purpose of this study was to investigate the association between primary payer and length of stay and cost, controlling for comorbidities and complications, in patients undergoing total laryngectomy. Methods: The sample included 4128 patients who underwent total laryngectomy in the 2005 to 2010 National Inpatient Sample (NIS). Patients were categorized into 4 subgroups based on payer status: Medicare, Medicaid, uninsured, and private insurance. Using multilevel modeling, we examined differences in length of stay and hospitalization costs. Results: The odds of being in the top quartile of length of stay increased for Medicaid patients by 41{\%} (odds ratio [OR] = 1.41; 95{\%} confidence interval [CI] = 1.03–1.92) compared with privately insured patients. Conclusion: After controlling for medical factors, Medicaid patients had increased lengths of stay. Overall costs were highest for those with public insurance, but no difference was seen for the adjusted cost.",
keywords = "bundled payments, hospital costs, laryngectomy, length of stay, Medicaid",
author = "Vikas Mehta and Flores, {Jos{\'e} M.} and Thompson, {Richard Will} and Nathan, {Cherie Ann}",
year = "2017",
month = "2",
day = "1",
doi = "10.1002/hed.24585",
language = "English (US)",
volume = "39",
pages = "311--319",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "Wiley-Liss Inc.",
number = "2",

}

TY - JOUR

T1 - Primary payer status, individual patient characteristics, and hospital-level factors affecting length of stay and total cost of hospitalization in total laryngectomy

AU - Mehta, Vikas

AU - Flores, José M.

AU - Thompson, Richard Will

AU - Nathan, Cherie Ann

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Medicaid and uninsured patients anecdotally incur higher cost and length of stay because of nonmedical, discharge-related factors. The purpose of this study was to investigate the association between primary payer and length of stay and cost, controlling for comorbidities and complications, in patients undergoing total laryngectomy. Methods: The sample included 4128 patients who underwent total laryngectomy in the 2005 to 2010 National Inpatient Sample (NIS). Patients were categorized into 4 subgroups based on payer status: Medicare, Medicaid, uninsured, and private insurance. Using multilevel modeling, we examined differences in length of stay and hospitalization costs. Results: The odds of being in the top quartile of length of stay increased for Medicaid patients by 41% (odds ratio [OR] = 1.41; 95% confidence interval [CI] = 1.03–1.92) compared with privately insured patients. Conclusion: After controlling for medical factors, Medicaid patients had increased lengths of stay. Overall costs were highest for those with public insurance, but no difference was seen for the adjusted cost.

AB - Background: Medicaid and uninsured patients anecdotally incur higher cost and length of stay because of nonmedical, discharge-related factors. The purpose of this study was to investigate the association between primary payer and length of stay and cost, controlling for comorbidities and complications, in patients undergoing total laryngectomy. Methods: The sample included 4128 patients who underwent total laryngectomy in the 2005 to 2010 National Inpatient Sample (NIS). Patients were categorized into 4 subgroups based on payer status: Medicare, Medicaid, uninsured, and private insurance. Using multilevel modeling, we examined differences in length of stay and hospitalization costs. Results: The odds of being in the top quartile of length of stay increased for Medicaid patients by 41% (odds ratio [OR] = 1.41; 95% confidence interval [CI] = 1.03–1.92) compared with privately insured patients. Conclusion: After controlling for medical factors, Medicaid patients had increased lengths of stay. Overall costs were highest for those with public insurance, but no difference was seen for the adjusted cost.

KW - bundled payments

KW - hospital costs

KW - laryngectomy

KW - length of stay

KW - Medicaid

UR - http://www.scopus.com/inward/record.url?scp=84992499064&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992499064&partnerID=8YFLogxK

U2 - 10.1002/hed.24585

DO - 10.1002/hed.24585

M3 - Article

C2 - 27653437

AN - SCOPUS:84992499064

VL - 39

SP - 311

EP - 319

JO - Head and Neck

JF - Head and Neck

SN - 1043-3074

IS - 2

ER -