COST

Table Description

The COST table captures records containing the cost of any medical event recorded in one of the OMOP clinical event tables such as DRUG_EXPOSURE, PROCEDURE_OCCURRENCE, VISIT_OCCURRENCE, VISIT_DETAIL, DEVICE_OCCURRENCE, OBSERVATION or MEASUREMENT.

Each record in the cost table account for the amount of money transacted for the clinical event. So, the COST table may be used to represent both receivables (charges) and payments (paid), each transaction type represented by its COST_CONCEPT_ID. The COST_TYPE_CONCEPT_ID field will use concepts in the Standardized Vocabularies to designate the source (provenance) of the cost data. A reference to the health plan information in the PAYER_PLAN_PERIOD table is stored in the record for information used for the adjudication system to determine the persons benefit for the clinical event.

User Guide

When dealing with summary costs, the cost of the goods or services the provider provides is often not known directly, but derived from the hospital charges multiplied by an average cost-to-charge ratio.

ETL Conventions

One cost record is generated for each response by a payer. In a claims databases, the payment and payment terms reported by the payer for the goods or services billed will generate one cost record. If the source data has payment information for more than one payer (i.e. primary insurance and secondary insurance payment for one entity), then a cost record is created for each reporting payer. Therefore, it is possible for one procedure to have multiple cost records for each payer, but typically it contains one or no record per entity. Payer reimbursement cost records will be identified by using the PAYER_PLAN_ID field. Drug costs are composed of ingredient cost (the amount charged by the wholesale distributor or manufacturer), the dispensing fee (the amount charged by the pharmacy and the sales tax).

CDM Field	User Guide	ETL Conventions	Datatype	Required	Primary Key	Foreign Key	FK Table	FK Domain
cost_id			integer	Yes	Yes	No
cost_event_id			integer	Yes	No	No
cost_domain_id			varchar(20)	Yes	No	Yes	DOMAIN
cost_type_concept_id			integer	Yes	No	Yes	CONCEPT
currency_concept_id			integer	No	No	Yes	CONCEPT
total_charge			float	No	No	No
total_cost			float	No	No	No
total_paid			float	No	No	No
paid_by_payer			float	No	No	No
paid_by_patient			float	No	No	No
paid_patient_copay			float	No	No	No
paid_patient_coinsurance			float	No	No	No
paid_patient_deductible			float	No	No	No
paid_by_primary			float	No	No	No
paid_ingredient_cost			float	No	No	No
paid_dispensing_fee			float	No	No	No
payer_plan_period_id			integer	No	No	No
amount_allowed			float	No	No	No
revenue_code_concept_id			integer	No	No	Yes	CONCEPT
revenue_code_source_value	Revenue codes are a method to charge for a class of procedures and conditions in the U.S. hospital system.		varchar(50)	No	No	No
drg_concept_id			integer	No	No	Yes	CONCEPT
drg_source_value	Diagnosis Related Groups are US codes used to classify hospital cases into one of approximately 500 groups.		varchar(3)	No	No	No