This wide variation not explained by patient or hospital characteristics
THURSDAY, Jan. 16, 2014 (HealthDay News) -- There is wide variation in hospital charges and discounted prices for uncomplicated vaginal and cesarean section births, according to a study published online Jan. 15 in BMJ Open.
Renee Y. Hsia, M.D., from the University of California in San Francisco, and colleagues utilized diagnosis-related group codes to identify all privately insured patients admitted to California hospitals in 2011 for 76,766 uncomplicated vaginal deliveries or 32,660 uncomplicated cesarean sections. Data were extracted from the California Office of Statewide Health Planning and Development.
The researchers found that after adjusting for patient demographic and clinical characteristics, the average California woman could be charged between $3,296 and $37,227 for a vaginal delivery, and between $8,312 and $70,908 for a cesarean section, depending on the hospital. On average, the discounted prices were 37 percent of the charges. There were significantly lower adjusted charges for vaginal deliveries in hospitals in markets with middling competition. There were higher adjusted charges in hospitals with higher wage indices and case mixes, as well as in for-profit hospitals. For cesarean sections, hospitals in markets with higher uninsurance rates charged significantly less, while for-profit hospitals and hospitals with higher wage indices charged more.
"However, the institutional and market-level factors included in our models explained only 35 to 36 percent of the between-hospital variation in charges," the authors write.
Abstract (http://bmjopen.bmj.com/content/4/1/e004017.abstract )Full Text (http://bmjopen.bmj.com/content/4/1/e004017.full )