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Pancreas fistula risk prediction: implications for hospital costs and payments

Abbott, Daniel E ; Tzeng, Ching Wei D ; McMillan, Matthew T ; Callery, Mark P ; Kent, Tara S ; Christein, John D ; Behrman, Stephen W ; Schauer, Daniel P ; Hanseman, Dennis J ; Eckman, Mark H ; Vollmer, Charles M

HPB (Oxford, England), 2017-02, Vol.19 (2), p.140-146 [Periódico revisado por pares]

England: Elsevier Ltd

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Título:
Pancreas fistula risk prediction: implications for hospital costs and payments
Autor: Abbott, Daniel E ; Tzeng, Ching Wei D ; McMillan, Matthew T ; Callery, Mark P ; Kent, Tara S ; Christein, John D ; Behrman, Stephen W ; Schauer, Daniel P ; Hanseman, Dennis J ; Eckman, Mark H ; Vollmer, Charles M
Assuntos: Gastroenterology and Hepatology ; Health Care Rationing - economics ; Health Expenditures - standards ; Health Services Needs and Demand - economics ; Hospital Costs - standards ; Hospital Mortality ; Humans ; Models, Economic ; Needs Assessment - economics ; Pancreatic Fistula - economics ; Pancreatic Fistula - etiology ; Pancreatic Fistula - mortality ; Pancreatic Fistula - therapy ; Pancreaticoduodenectomy - adverse effects ; Pancreaticoduodenectomy - economics ; Pancreaticoduodenectomy - mortality ; Pancreaticoduodenectomy - standards ; Patient Readmission - economics ; Process Assessment (Health Care) - economics ; Process Assessment (Health Care) - standards ; Quality Indicators, Health Care ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; United States
É parte de: HPB (Oxford, England), 2017-02, Vol.19 (2), p.140-146
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SourceType-Scholarly Journals-1
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Descrição: Abstract Background As payment models evolve, disease-specific risk stratification may impact patient selection and financial outcomes. This study sought to determine whether a validated clinical risk score for post-operative pancreatic fistula (POPF) could predict hospital costs, payments, and profit margins. Methods A multi-institutional cohort of 1193 patients undergoing pancreaticoduodenectomy (PD) were matched to an independent hospital where cost, in US$, and payment data existed. An analytic model detailed POPF risk and post-operative sequelae, and their relationship with hospital cost and payment. Results Per-patient hospital cost for negligible-risk patients was $37,855. Low-, moderate-, and high- risk patients had incrementally higher hospital costs of $38,125 ($270; 0.7% above negligible-risk), $41,128 ($3273; +8.6%), and $41,983 ($3858; +10.9%), respectively. Similarly, hospital payment for negligible-risk patients was $42,685/patient, with incrementally higher payments for low-risk ($43,265; +1.4%), moderate-risk ($45,439; +6.5%) and high-risk ($46,564; +9.1%) patients. The lowest 30-day readmission rates – with highest net profit – were found for negligible/low-risk patients (10.5%/11.1%), respectively, compared with readmission rates of moderate/high-risk patients (15%/15.7%). Conclusion Financial outcomes following PD can be predicted using the FRS. Such prediction may help hospitals and payers plan for resource allocation and payment matched to patient risk, while providing a benchmark for quality improvement initiatives.
Editor: England: Elsevier Ltd
Idioma: Inglês

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Pancreas fistula risk prediction: implications for hospital costs and payments

Abbott, Daniel E ; Tzeng, Ching Wei D ; McMillan, Matthew T ; Callery, Mark P ; Kent, Tara S ; Christein, John D ; Behrman, Stephen W ; Schauer, Daniel P ; Hanseman, Dennis J ; Eckman, Mark H ; Vollmer, Charles M

England: Elsevier Ltd

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