Table 2 Microcosting data items required from Calgary, Alberta sites
Variable | Description | Data required | Data source |
|---|---|---|---|
Baseline/Admission data | |||
Patient unique identifier | Single datum permitting linkage across multiple databases | Unique Lifetime Identifier | COOL trial |
Hospital at enrolment | Hospital where initial laparotomy is performed | Site name | COOL trial |
Patient postal code | Approximate location of patient’s domicile (necessary for calculating transportation costs) | Postal code | COOL trial |
Patient age | In years | Age in years | COOL trial |
Patient sex | Male, female, other | Sex | COOL trial |
ICD-10 admission diagnosis | Single admission diagnosis | ICD-10 code | COOL trial |
Shock at the time of initial OR | Hypotension requiring pressors for MAP > 65 or serum lactate > 2 mmol/L after resuscitation | Yes/No | COOL trial |
Admission APACHE II score | Severity-of-disease classification score | Score at time of admission | COOL trial |
Index hospitalization | |||
Operating room | |||
Dates of each operating room encounter | During index hospitalization | List of dates | COOL trial |
Procedures performed at each operating room encounter | All procedure codes included | List of procedure codes | COOL trial |
Duration of all operating room encounters | Documented entry into and exit from operating room | Time in minutes | COOL trial |
Anesthetist billings associated with each operating room encounter | Total physician claims | Billings in CAD | Alberta Medical Association (AMA) fee schedule |
Surgeon billings associated with each operating room encounter | Total physician claims | Billings in CAD | AMA fee schedule |
Operating room drug costs | List, quantity, and cost of all medications used during surgery | Medications and costs | Finance oracle microcosting database (Oracle) |
List and quantity of disposables used at each surgical encounter | All non-sterilizable surgical tools designed for one-time use, as well as suture materials and dressings | List and quantity | Oracle |
Surgical instrument sets used at each surgical encounter | Name of each set used (e.g., major abdominal) | List of instrument sets | Oracle |
Postoperative care | |||
Length of stay in ICU and cost | Stay in a designated critical care environment | Length in days | COOL trial, Oracle |
Length of stay on general ward and cost | Length of hospital stay, less the length of ICU stay | Length in days | COOL trial, Oracle |
Length of stay in post-anesthesia care unit | Stay in a designated PACU | Length in days | Oracle |
Direct and indirect costs of PACU stay | Itemized cost of PACU stay including personnel, disposables, medications, and overhead costs | Costs in CAD | Oracle |
Physician billings associated with hospital stay | Total Alberta Health billings, less surgeon, and anesthetist operative billings | Billings in CAD | AHS data analytics (DIMR) |
Postoperative diagnostic imaging costs | Total of per-study fees, plus the AHS billings of diagnostic radiologists | Costs in CAD | Oracle |
Postoperative percutaneous procedure costs | Total of per-procedure fees, plus the AHS billings of interventional radiologists | Costs in CAD | Oracle |
Costs of laboratory testing | Total in-hospital laboratory testing, less total study-specific laboratory testing costs | Costs in CAD | Oracle |
Inpatient drug costs | Total pharmaceutical costs | Costs in CAD | Oracle |
Cost of blood products used | Total cost of in-hospital blood product use | Costs in CAD | Oracle |
Cost of nursing and allied health care not included in per-diem unit cost | Total cost of specialized RN and other allied health providers | Costs in CAD | Oracle |
Cost of disposables used in postoperative patient care | Total cost of disposables | Costs in CAD | Oracle |
Follow-up care | |||
Number of surgeon visits (to 1 year) | Regardless of reason for visit | Number of visits | DIMR |
Number of other specialist physician visits (to 1 year) | Regardless of reason for visit | Number of visits | DIMR |
Total outpatient AHS billings | Regardless of reason for services | Billings in CAD | DIMR |
Readmissions | |||
Number and length of each readmission within 1 year | Regardless of reason for readmission | Number and length in days | DIMR |
Total hospital cost, including physician billings, associated with each readmission | Regardless of reason for visit | Costs in CAD | DIMR |
Subsequent OR costs | |||
Dates of each operating room encounter within 1 year | After index hospitalization | List of dates | COOL trial |
Procedures performed at each operating room encounter | All procedure codes included | List of procedure codes | COOL trial |
Duration of all operating room encounters | Documented entry into and exit from operating room | Time in minutes | COOL trial |
Anesthetist billings associated with each operating room encounter | Total physician claims | Billings in CAD | AMA Fee Schedule |
Surgeon billings associated with each operating room encounter | Total physician claims | Billings in CAD | AMA Fee Schedule |
List and quantity of disposables used at each surgical encounter | All non-sterilizable surgical tools designed for one-time use, as well as suture materials and dressings | List and quantity | Oracle |
Surgical instrument sets used at each surgical encounter | Name of each set used (e.g., major abdominal) | List of instrument sets | Oracle |
Ambulatory care costs | |||
Number, type, and cost of all other ambulatory encounters (other than family physician and specialist encounters) | All day medicine and day surgery encounters (including dialysis) within one year | Number, type, and costs in CAD | DIMR |
Costs to patients and caregivers | |||
Cost of transportation to and from family physician and specialist appointments | Total estimated costs | Number of visits, approximate distance to domicile | DIMR |
Productivity costs | |||
Number of days absent from work at 1 year | Self-reported number of days absent from work | Total days | COOL trial |
Outcomes | |||
Mortality at 90 days | Primary outcome | Dichotomous variable | COOL trial |
Mortality at 1 year | Long-term survival | Dichotomous variable | COOL trial |
Presence of a stoma at initial hospital discharge | Ileostomy or colostomy | Dichotomous variable | COOL trial |
Presence of a stoma at 90 days and 1 year | Ileostomy or colostomy | Dichotomous variable | COOL trial |
EQ-5D-5 L and SF-36 at 90 days | Validated quality of life measure | Values at 90 days | COOL trial |
EQ-5D-5 L and SF-36 at 1 year | Validated quality of life measure | Values at one year | COOL trial |