Variance in Hospital Charges and in-Patient Care for Liver Transplants: Examining Non-Clinical Predictors and Implications

The significant and apparent variance in hospital charges and inpatient care in the U.S. has perplexed the general public including many stakeholders such as the healthcare regulators and insurers. While the clinical side of inpatient care has been undergoing tremendous progress and standardization, the overall cost of healthcare has been ballooning. The purpose of this research is to conduct statistical analyses that reveal the sources of variance in hospital charges and inpatient care using the annual data from the AHRQ's (Agency for Healthcare Research and Quality) HCUP's (Hospital Cost and Utilization Project) NIS (National Inpatient Sample) database. Our focus is on non-clinical factors such as patient age, gender, income and race and hospital location data as independent variables to investigate their impact on hospital charges and inpatient care. Our research sample is the liver transplant cases in 2019 sampled in the NIS 2019 database. Our regression results show patient age and gender as well as payer affect the number of diagnoses; and hospital charges are affected by age, payer and hospital location. Number of procedures was not affected by any of these non-clinical factors except the hospital location. Implications suggest that there is more room for standardization of the number of diagnoses and procedures across regions in the US. Results also reveal that race and income do not have any effect on hospital charges and inpatient care. Our study contributes to an empirical understanding of non-clinical factors in the explanation of variance in hospital charges and inpatient care.