OMOP/Documentation/CommonDataModel_Wiki_Files/StandardizedHealthEconomicsDataTables/COST.md

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.

Field	Required	Type	Description
cost_id	Yes	integer	A unique identifier for each COST record.
person_id	Yes	integer	A unique identifier for each PERSON.
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_event_field_concept_id	Yes	integer	A foreign key identifier to a concept in the CONCEPT table representing the identity of the field represented by COST_EVENT_ID
cost_concept_id	Yes	integer	A foreign key that refers to a Standard Cost Concept identifier in the Standardized Vocabularies belonging to the 'Cost' vocabulary.
cost_type_concept_id	Yes	integer	A foreign key identifier to a concept in the CONCEPT table for the provenance or the source of the COST data and belonging to the 'Cost Type' vocabulary
cost_source_concept_id	No	integer	A foreign key to a Cost Concept that refers to the code used in the source.
cost_source_value	No	varchar(50)	The source value for the cost as it appears in the source data
currency_concept_id	Yes	integer	A foreign key identifier to the concept representing the 3-letter code used to delineate international currencies, such as USD for US Dollar. These belong to the 'Currency' vocabulary
cost	Yes	float	The actual financial cost amount
incurred_date	Yes	date	The first date of service of the clinical event corresponding to the cost as in table capturing the information (e.g. date of visit, date of procedure, date of condition, date of drug etc).
billed_date	No	date	The date a bill was generated for a service or encounter
paid_date	No	date	The date payment was received for a service or encounter
revenue_code_concept_id	No	integer	A foreign key referring to a Standard Concept ID in the Standardized Vocabularies for Revenue codes belonging to the 'Revenue Code' vocabulary.
drg_concept_id	No	integer	A foreign key referring to a Standard Concept ID in the Standardized Vocabularies for DRG codes belonging to the 'DRG' vocabulary.
revenue_code_source_value	No	varchar(50)	The source value for the Revenue code as it appears in the source data, stored here for reference.
drg_source_value	No	varchar(50)	The source value for the 3-digit DRG source code as it appears in the source data, stored here for reference.
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. Record the payer_plan_id that relates to the payer who contributed to the paid_by_payer field.

Conventions

No.	Convention Description
1	The cost information is linked through the COST_EVENT_ID field to its entity, which denotes a record in a table referenced by the COST_EVENT_FIELD_CONCEPT_ID field.
2	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.
3	One cost record is generated for each money or currency amount associated with a record in one of the event tables.
4	The COST field represents the dollar amount, either incoming or outgoing
5	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. This data is currently available for NIS datasets, or any other HCUP datasets. See also cost calculation explanation from AHRQ
7	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).
8	In claims data, generally there is one field representing the total payment from the payer for the service/device/drug. However, this field could be a calculated field if the source data provides separate payment information for the ingredient cost and the dispensing fee in case of prescription benefits. If there is more than one Payer in the source data, several cost records indicate that fact. The Payer reporting this reimbursement should be indicated under the PAYER_PLAN_ID field.
10	REVENUE_CODE_CONCEPT_ID: Revenue codes are a method to charge for a class of procedures and conditions in the U.S. hospital system.
11	DRG_CONCEPT_ID: Diagnosis Related Groups are US codes used to classify hospital cases into one of approximately 500 groups. Only the MS-DRG system should be used (mapped to vocabulary_id 'DRG) and all other DRG values should be mapped to 0.

The COST table will store information reporting money or currency amounts. There are three types of cost data, defined in the COST_TYPE_CONCEPT_ID:

1. Payer is primary (coordination of benefit)
2. Payer is secondary (coordination of benefit)
3. Premium

One cost record is generated for each money or currency amount associated with a record in one of the event tables. For example, a raw record that looks like this:

patient_id	cob	coins	copay	deduct	net	total_pay	pddate	proc_cd	procmod	revcode	svcdate
175127601	0	0	22	3	88	113	2/28/2000	82378			1/1/2000

Will create four lines in the COST table:

cost_id	person_id	cost_event_id	cost_event_field_concept_id	cost_concept_id	cost_type_concept_id	cost_source_concept_id	currency_concept_id	cost	incurred_date	billed_date	paid_date	revenue_code_concept_id	drg_concept_id	revenue_code_source_value	drg_source_value	payer_plan_period_id
1	175127601	1002	TBD	1234	5032	0	44818668	22	1/1/2000		2/28/2000	0	0			3045
2	175127601	1002	TBD	2345	5032	0	44818668	3	1/1/2000		2/28/2000	0	0			3045
3	175127601	1002	TBD	3456	5032	0	44818668	88	1/1/2000		2/28/2000	0	0			3045
4	175127601	1002	TBD	4567	5032	0	44818668	113	1/1/2000		2/28/2000	0	0			3045

No.	Convention Description
1	The cost information is linked through the COST_EVENT_ID field to its entity, which denotes a record in a table referenced by the COST_EVENT_FIELD_CONCEPT_ID field.
2	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.
3	One cost record is generated for each money or currency amount associated with a record in one of the event tables.
4	The COST field represents the dollar amount, either incoming or outgoing
5	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. This data is currently available for NIS datasets, or any other HCUP datasets. See also cost calculation explanation from AHRQ
7	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).
8	In claims data, generally there is one field representing the total payment from the payer for the service/device/drug. However, this field could be a calculated field if the source data provides separate payment information for the ingredient cost and the dispensing fee in case of prescription benefits. If there is more than one Payer in the source data, several cost records indicate that fact. The Payer reporting this reimbursement should be indicated under the PAYER_PLAN_ID field.
10	REVENUE_CODE_CONCEPT_ID: Revenue codes are a method to charge for a class of procedures and conditions in the U.S. hospital system.
11	DRG_CONCEPT_ID: Diagnosis Related Groups are US codes used to classify hospital cases into one of approximately 500 groups. Only the MS-DRG system should be used (mapped to vocabulary_id 'DRG) and all other DRG values should be mapped to 0.