Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score

Abstract

Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status.

Figure 1

The average charge per patient within six categories of service based on patients' ASA scores. Total average charges are also presented.

Figure 2

The average frequency of services per patient based on patients' ASA scores. The total average frequency of services is also provided.

Figure 3

The average charges per patient related to postoperative services based on patients' ASA scores. Total average charges are also presented.

Figure 4

The average frequency of postoperative services per patient based on patients' ASA scores. The total average frequency of services is also provided.