Relationship Between Surgery Outcomes and Hospital Costs?
Relationship Between Surgery Outcomes and Hospital Costs?
Birkmeyer JD, Gust C, Dimick JB, Birkmeyer NJ, Skinner JS
Ann Surg. 2012;255:1-5
Will the effort to increase the quality of surgical care affect cost? If so, what might be the anticipated cost savings associated with better-quality surgical care? The investigators studied this relationship in US surgical patients undergoing major surgical procedures. Wide differences in complication rates were found. For colectomy, as an example, complication rates ranged from 12.6% to 28.8% when best-performing and worst-performing hospitals were compared. The investigators also found a strong association between payments for each procedure and complication rates. For example, in top-performing hospitals, coronary artery bypass grafting cost about $5300 less than in hospitals with the highest complication rates (P = .001).
In this study that was based on US Medicare data, reducing complication rates resulted in a significant decrease in total cost for patients undergoing major surgery. The estimated savings would be a bonus in addition to the lower mortality associated with lower complication rates, and the generated savings are likely to be much greater than the extra effort required to reduce complication rates. This report provides additional information to the current discussion about referring patients who require high-risk surgery to centers of excellence.
Abstract
Hospital Quality and the Cost of Inpatient Surgery in the United States
Birkmeyer JD, Gust C, Dimick JB, Birkmeyer NJ, Skinner JS
Ann Surg. 2012;255:1-5
Summary
Will the effort to increase the quality of surgical care affect cost? If so, what might be the anticipated cost savings associated with better-quality surgical care? The investigators studied this relationship in US surgical patients undergoing major surgical procedures. Wide differences in complication rates were found. For colectomy, as an example, complication rates ranged from 12.6% to 28.8% when best-performing and worst-performing hospitals were compared. The investigators also found a strong association between payments for each procedure and complication rates. For example, in top-performing hospitals, coronary artery bypass grafting cost about $5300 less than in hospitals with the highest complication rates (P = .001).
Viewpoint
In this study that was based on US Medicare data, reducing complication rates resulted in a significant decrease in total cost for patients undergoing major surgery. The estimated savings would be a bonus in addition to the lower mortality associated with lower complication rates, and the generated savings are likely to be much greater than the extra effort required to reduce complication rates. This report provides additional information to the current discussion about referring patients who require high-risk surgery to centers of excellence.
Abstract
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