COSTS ASSOCIATED WITH PRESSURE WOUNDS IN THE U.S. INPATIENT HOSPITAL POPULATION
Bibliographic record
Abstract
The 2008 Hospital-Acquired Conditions Initiative from CMS prohibited hospitals from receiving extra Medicare and/or Medicaid payments for hospital-acquired stage III and IV pressure ulcers and all stage I and II pressure ulcers. Previous research has estimated costs attributable to pressure ulcers with the use of multiple regression modeling, which may not adequately adjust for differences in health and disease status between patients who do and do not develop pressure ulcers. The purpose of this study was to employ propensity score matching (PSM) to estimate the incremental cost of pressure ulcers among a nationally representative inpatient population. All patients with a diagnosed pressure ulcer (N= 948,930) were identified from the 2012 National Inpatient Sample Database. Average unadjusted inpatient episode costs were $66,064 (± $967) and $35,844 (± $440) for patients with and without pressure ulcers, respectively. Using PSM, patients with pressure ulcers were matched to patients without pressure ulcers on sex, age, race/ethnicity, urban vs. rural residence, median income quartile of residential zip code, diagnosis of malnutrition, as well as the quantity of chronic conditions and diagnoses listed on the patient record. In the PSM-matched sample (N=1,896,450), the average total cost for patients with pressure ulcers was $66,779 (± $981) compared to $54,511 (± $552, p < .0001) for those without pressure ulcers, a difference of 22.5%. Health care systems that focus efforts on reducing the incidence and duration of pressure ulcers in their inpatient populations have the potential to realize significant savings, even among high-acuity patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".