Surgical Management of Congenital Heart Disease: Correlation between Hospital Costs and the Aristotle Complexity Score

Abstract

Background: Hospital costs are expected to correlate with clinical complexity. Do costs for congenital heart surgery correlate with Aristotle complexity scores? Methods: 442 inpatient stays in 2008 were evaluated. Aristotle scores and levels were determined. Costs were estimated according to the German Institute for Hospital Reimbursement system. Pearson and Spearman r correlation coefficients and corresponding goodness-of-fit regression coefficients r² were calculated. Results: Mean basic and comprehensive Aristotle scores were 7.60 ± 2.74 and 9.23 ± 2.94 points, respectively. Mean expenses per hospital stay amounted to 29 369 ± 30 823 Euros. Aristotle basic and comprehensive scores and levels were positively correlated with hospital costs. With a Spearman r of 1 and related r² of 0.9436, scores of the 6 Aristotle comprehensive levels correlated best. Mean hospital reimbursement was 26 412 ± 17 962 Euros. Compensation was higher than expenses for patients in comprehensive levels 1 to 3, but much lower for those in levels 4 to 6. Conclusions: Aristotle comprehensive complexity scores were highly correlated with hospital costs. The Aristotle score could be used as a scale to establish the correct reimbursement after congenital heart surgery.

Key words

cardiovascular surgery - heart defects - congenital - risk scores - health economy

References

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