Associate Director and Chief, Division of Health Policy and Quality, Houston VA Center for Quality of Care and Utilization Studies | Associate Professor, Section for Health Services Research Department of Medicine, Baylor College of Medicine
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Background: We examined whether higher procedure volumes for coronary artery bypass graft (CABG) surgery or percutaneous coronary interventions (PCI) were associated with lower costs per patient, and if so, estimated the financial savings from regionalizing cardiac procedures.
Methods: Cost regressions with hospital-specific dummy variables measured within-hospital cost reductions associated with increasing hospital volume. We used the regression estimates to predict the change in total costs that would result from moving patients in low-volume hospitals to higher-volume facilities.
Results: A 10 percent increase in PCI procedure volume lowered costs per patient by 0.7 percent. For the average hospital performing CABG in 2000, a 10 percent increase in volume was associated with a 2.8 percent reduction in average costs. Despite these lower costs, the predicted savings from regionalizing all PCI procedures in the sample from lower- to high-volume hospitals amounted to only 1.1 percent of the entire costs of performing PCI procedures for the sample in 2000. Similarly, the cost savings for CABG were estimated to be only 3.5 percent.
Conclusions: Higher volumes were associated with lower costs per procedure. However, the total potential savings from regionalizing cardiac procedures is relatively minor, and may not justify the risks of reducing access to needed services.
Published in Cost Effectiveness and Resource Allocation.
