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 questions remain about clinical and economic implications of widespread application of LVRS. In this report, we describe hospital costs, excluding physicians' fees, for LVRS. Design: Hospital charges were obtained from billing records and converted to costs by applying multiple cost-to-charge ratios. Setting: A large, urban academic medical center. Patients: Fifty-two consecutive patients who received bilateral LVRS through a median sternotomy between April 1995 and August 1996. Results: Median hospital stay was 10 days (mean 14.8+/-12.8 days; range=3 to 48 days), including 2 days (mean=6+/-9.2 days; range 1 to 35 days) in the ICU. 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 length of hospitalization. Patients who accrued the highest costs were significantly older than the remainder of the sample (69.3 years vs 62.4 years). Conclusions: Hospital costs of LVRS vary significantly but are related directly to hospital stay. Identification of factors associated with prolonged stays can be used in assessing benefits and risks of LVRS against utilization of health-care dollars.