Observational Health Data Sciences and Informatics

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Single Cost Table

Requester: Jennifer Durea

Proposal to consolidate all current cost tables (Procedure_Cost, Drug_Cost, Device_Cost, Visit_Cost) in V5.0 into one single table. The table could be connected to any of the Domain tables (Procedure_Occurrence, Condition_Occurrence, Drug_Exposure, Device_Exposure, Observation, Measurement).

Instead of generating additional cost tables, each tied to a specific domain, perhaps we create a single, unified cost table to capture costs for all domains. visit_cost and device_cost share identical columns for tracking costs.

The discussion of this is here.

Field	Required	Type	Description
cost_id	Yes	integer	A unique identifier for each COST record.
cost_event_id	Yes	integer	A foreign key identifier to the event (e.g. Measurement, Procedure, Visit, Drug Exposure, etc) record for which cost data are recorded.
cost_domain_id	Yes	string(20)	The concept representing the domain of the cost event, from which the corresponding table can be inferred.
currency_concept_id	No	integer	A concept representing the 3-letter code used to delineate international currencies, such as USD for US Dollar.
charge	No	float	The amount charged by the provider of the good/service (e.g. hospital, physician pharmacy, dme provider).
paid_copay	No	float	The amount paid by the Person as a fixed contribution to the expenses. Copay does not contribute to the out of pocket expenses.
paid_coinsurance	No	float	The amount paid by the Person as a joint assumption of risk. Typically, this is a percentage of the expenses defined by the Payer Plan after the Person's deductible is exceeded.
paid_toward_deductible	No	float	The amount paid by the Person that is counted toward the deductible defined by the Payer Plan.
paid_by_payer	No	float	The amount paid by the Payer. If there is more than one Payer, several DRUG_COST records indicate that fact.
paid_by_coordination_benefits	No	float	The amount paid by a secondary Payer through the coordination of benefits.
total_out_of_pocket	No	float	The total amount paid by the Person as a share of the expenses.
total_paid	No	float	The total amount paid for the expenses of drug exposure.
ingredient_cost	No	float	The portion of the drug expenses due to the cost charged by the manufacturer for the drug, typically a percentage of the Average Wholesale Price.
dispensing_fee	No	float	The portion of the drug expenses due to the dispensing fee charged by the pharmacy, typically a fixed amount.
cost	No	float	Cost of service/device/drug incurred by provider/pharmacy. Was “average_wholesale_price” which represented: “List price of a Drug set by the manufacturer”.
payer_plan_period_id	No	integer	A foreign key to the PAYER_PLAN_PERIOD table, where the details of the Payer, Plan and Family are stored.
amount_allowed	No	float	The contracted amount agreed between the payer and provider.
revenue_code_concept_id	No	integer	A foreign key referring to a Standard Concept ID in the Standardized Vocabularies for Revenue codes.
revenue_code_source_value	No	string(50)	The source code for the Revenue code as it appears in the source data, stored here for reference.