LUNG-VOLUME REDUCTION SURGERY - AN ANALYSIS OF HOSPITAL COSTS

Objective: Lung volume reduction surgery (LVRS) represents a potential breakthrough in the management of advanced emphysema, although questi ons remain about clinical and economic implications of widespread appl ication of LVRS. In this report, we describe hospital costs, excluding physicians' fees, for LVRS. Design: Hospital charges were obtained fr om billing records and converted to costs by applying multiple cost-to -charge ratios. Setting: A large, urban academic medical center. Patie nts: Fifty-two consecutive patients who received bilateral LVRS throug h a median sternotomy between April 1995 and August 1996. Results: Med ian hospital stay was 10 days (mean 14.8+/-12.8 days; range=3 to 48 da ys), including 2 days (mean=6+/-9.2 days; range 1 to 35 days) in the I CU. One hospital death occurred. Hospital costs per case ranged from $ 11,712 to $121,829, with mean costs of $30,976 and median costs of $19 ,771. Costs were related significantly to duration of ICU stay and len gth of hospitalization. Patients who accrued the highest costs were si gnificantly older than the remainder of the sample (69.3 years vs 62.4 years). Conclusions: Hospital costs of LVRS vary significantly but ar e related directly to hospital stay. Identification of factors associa ted with prolonged stays can be used in assessing benefits and risks o f LVRS against utilization of health-care dollars.