1. Can high healthcare costs be reduced? - Empirical evidence from community hospitals Haichang Xin 1, PhD, Mark L. Diana 2, PhD, Anjum Khurshid 3, PhD, Lisanne Brown 3, PhD, Snigdha Mukherjee 3, PhD 1.University of Alabama at Birmingham; 2. Tulane University; 3. Louisiana Public Health Institute

2. Presenter Disclosures Haichang Xin, PhD No relationships to disclose

3. Hospital inpatient costs comprise the largest proportion of health care expenditures. This study examines cost drivers and cost savings attributed to preventable hospital admissions. The results will inform policies on cost containment. Introduction and Objectives

4. Retrospective study design Hospital discharge data Jefferson and Orleans parishes Patients ages 18 and older Methods---Overall

5. High cost defined as top ten percentile charges, over $14,682.5 Patient characteristics, including age group, gender, race, insurance status, treatment categories, and length of stay Logit model Methods---Cost Drivers

6. Ambulatory care sensitive conditions Prevention quality indicators (PQIs) from AHRQ Preventable hospital admissions in 2010 Diabetes and heart disease Cost charge ratio converts charges to costs Methods--- Cost Savings

7. 1612 diabetes discharges and 3228 heart disease discharges A total related cost of $49.2 million Insignificant difference among age group, gender, and race Significant results (P<0.05): Medicare and other type insurance, compared to Medicaid; Urology medicine and general surgery; Longer patient length of stay Results---Cost Driver

8. Results---Cost Savings Number of Preventable Hospital Admission (N) Preventable Hospitalization Costs ($) Diabetes284.54.5 million Heart disease 666.37.5 million Total 12 million

9. More research needed for cost reduction from patient side Substantial room for cost savings from provider side on ambulatory care quality Future endeavors should identify specific areas on cost containment Conclusions