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MIMIC Code Repository: Code shared by the research community for the MIMIC family of databases
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Estimating costs or charges per hospitalisation #1054

Closed arielhasidim closed 3 years ago

arielhasidim commented 3 years ago

Hello, I intend to estimate hospitalisation costs or charge. I can see that CPT is not relevant for hospitalisation, its more about DRGs and procedural-ICDs, while hospitalisation had 1/2 main DRGs and ICDs is richer per hospitalisation (as stated at the docs, and by my sampling).

Is there any proper way to address this issue? Maybe a published article that already done that with MIMIC?

Best Regards, Ariel

alistairewj commented 3 years ago

I can't say I have an exact answer, but that act of congress a few years ago forced more price transparency from all US hospitals. You can wget the costs associated with DRG codes here: https://www.bidmc.org/-/media/rich-text-images/beth-israel-org/patient-and-visitor-information/patient-information/beth_israel_deaconess_medical_center_standard_charges_02242021.xml

Those apply for 2020 (I think).. but maybe it's a good start?

arielhasidim commented 3 years ago

I can't say I have an exact answer, but that act of congress a few years ago forced more price transparency from all US hospitals. You can wget the costs associated with DRG codes here: https://www.bidmc.org/-/media/rich-text-images/beth-israel-org/patient-and-visitor-information/patient-information/beth_israel_deaconess_medical_center_standard_charges_02242021.xml

Those apply for 2020 (I think).. but maybe it's a good start?

It's a very good start compare to what I had until now, Thank you!

When I checked the data I noticed that every hospitalisation had like 2 DRG's that has the same meaning, but it had much more reacher procedural-ICD codes,

Maybe there is a way to estimate costs by ICD's (procedural)? or maybe my approach is wrong and the billing is not thorough and include every procedure, just a fixed price according to the main DRG?

ICDs: hospitalization_id icd_version icd_code long_title
20107452 10 021209W Bypass Coronary Artery, Three Arteries from Aorta with Autologous Venous Tissue, Open Approach
20107452 10 B211YZZ Fluoroscopy of Multiple Coronary Arteries using Other Contrast
20107452 10 02100Z9 Bypass Coronary Artery, One Artery from Left Internal Mammary, Open Approach
20107452 10 06BQ4ZZ Excision of Left Saphenous Vein, Percutaneous Endoscopic Approach
20107452 10 5A1221Z Performance of Cardiac Output, Continuous
compare to: hospitalization_id drg_type drg_code description
20107452 HCFA 234 CORONARY BYPASS W CARDIAC CATH W/O MCC
20107452 APR 166 CORONARY BYPASS W/O AMI OR COMPLEX PDX
alistairewj commented 3 years ago

Yes I'd only pick one type of DRG. They just report the two equivalent versions. One of them has more information regarding severity/mortality for more precise estimate of patient severity. From the few health economics papers I've seen most use DRG as a proxy for total cost and don't go further than that, though including the ICDs will give you a more complete picture. I don't know exactly how the total cost is calculated but ICDs must be used as if they didn't affect the total bill they wouldn't bother to create them!

arielhasidim commented 3 years ago

Thank you very much John!