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The Paradox of Higher Charges for Lower-Risk Inpatient Admissions: When Healthier Patients Cost More

机译：低风险住院入住录取的较高费用的悖论：当更健康的患者花费更多时

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Risk stratification is essential to achieving the Triple Aim of better health, better care, and lower costs. Although risk tiers based on chronic disease diagnoses and recent healthcare utilization were predictive of healthcare utilization and charges in a managed population, their correlation with specific high-cost outcomes was unknown. More detailed analyses were performed to confirm that admissions for higher-risk patients were more expensive. However, these analyses found that charges for admissions of high-risk patients were actually not more expensive but 33% less expensive. The billing categories of implants, surgery, and supplies accounted for 93% of this difference. These findings may reflect that high-risk patients are less often appropriate candidates for elective surgery. An understanding of this difference, especially if validated by claims data and replicated in other populations, may lead to important insights into using risk stratification for predicting health services utilization in managed care populations.
机译：风险分层对于实现更好的健康，更好的护理和降低成本的三重目的至关重要。虽然基于慢性疾病诊断的风险层和最近的医疗保健利用率预测了管理人群的医疗利用和收费，但它们与特定高成本结果的相关性未知。进行更详细的分析以证实更高风险患者的入学更昂贵。然而，这些分析发现，高风险患者的入学费用实际上并不昂贵，但便宜33％。植入物，手术和用品的结算类别占这一差异的93％。这些发现可能反映出高危患者的往往是适当的选择性手术的候选人。对这种差异的理解，特别是在其他人群中验证，特别是在其他人群中验证，可能导致对使用风险分层来预测托管护理人群的卫生服务利用的重要见解。

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