Economic aspects of lung volume reduction surgery.

OBJECTIVE To investigate the economics of lung volume reduction surgery. DESIGN Medical center and physician charges obtained from billing records. SETTING Academic health center. PATIENTS Twenty-three consecutive patients undergoing lung volume reduction surgery at a single institution who were discharged from the hospital prior to November 1, 1995. OUTCOME MEASURES Length of hospital stay, mortality, medical center charges and professional fees, and sponsor reimbursement. RESULTS Median hospital stay was 8.0 days and there were no deaths. The median charge was $26,669 (range, $20,032 to $75,561) of which 73% was for medical center services and 27% was for physician services. Fees for medical center rooms and operating suite time accounted for 71% of medical center charges. Charges by surgeons and anesthesiologists accounted for 77% of professional fees. Total charges were directly related to length of stay (r2 = 0.95). Median reimbursement for medical center services was $22,264 (114%; range, $13,333 to $123,362) and for physician services was $2,783 (34%; range, $2,597 to $11,265), resulting in a median total reimbursement that represented 94% of total charges. The median reimbursement-to-cost ratio was 1.22, compared with 1.05 for all medical services in fiscal year 1995. CONCLUSIONS These data must now be assessed relative to outcomes such as quality of life, patient function, and long-term survival to determine cost-effectiveness of lung volume reduction surgery.