Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims
Aim: To compare the length of stay, hospital costs and hospital revenues for Medicare patients with and without a subset of potentially preventable postoperative complications after major noncardiac surgery. Materials & methods: Retrospective data analysis using the Medicare Standard Analytica...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Becaris Publishing Limited
2023-06-01
|
| Series: | Journal of Comparative Effectiveness Research |
| Subjects: |
| _version_ | 1797688102913835008 |
|---|---|
| author | Samer Haidar Reynaldo Vazquez Goran Medic |
| author_facet | Samer Haidar Reynaldo Vazquez Goran Medic |
| author_sort | Samer Haidar |
| collection | DOAJ |
| description | Aim: To compare the length of stay, hospital costs and hospital revenues for Medicare patients with and
without a subset of potentially preventable postoperative complications after major noncardiac surgery.
Materials & methods: Retrospective data analysis using the Medicare Standard Analytical Files, Limited
Data Set, 5% inpatient claims files for years 2016–2020. Results: In 74,103 claims selected for analysis,
71,467 claims had no complications and 2636 had one or more complications of interest. Claims with
complications had significantly longer length of hospital stay (12.41 vs 3.95 days, p < 0.01), increased
payments to the provider ($34,664 vs $16,641, p < 0.01) and substantially higher estimates of provider
cost ($39,357 vs $16,158, p < 0.01) compared with claims without complications. This results on average
in a negative difference between payments and costs for patients with complications compared with a
positive difference for claims without complications (-$4693 vs $483, p < 0.01). Results were consistent
across three different cost estimation methods used in the study. Conclusion: Compared with patients
without postoperative complications, patients developing complications stay longer in the hospital and
incur increased costs that outpace the increase in received payments. Complications are therefore costly
to providers and payers, may negatively impact hospital profitability, and decrease the quality of life
of patients. Quality initiatives aimed at reducing complications can be immensely valuable for both
improving patient outcomes and hospital finances. |
| first_indexed | 2024-03-12T01:26:56Z |
| format | Article |
| id | doaj.art-13ded52d68094143b04b567f4d7b6b40 |
| institution | Directory Open Access Journal |
| issn | 2042-6313 |
| language | English |
| last_indexed | 2024-03-12T01:26:56Z |
| publishDate | 2023-06-01 |
| publisher | Becaris Publishing Limited |
| record_format | Article |
| series | Journal of Comparative Effectiveness Research |
| spelling | doaj.art-13ded52d68094143b04b567f4d7b6b402023-09-12T14:37:06ZengBecaris Publishing LimitedJournal of Comparative Effectiveness Research2042-63132023-06-0112710.57264/cer-2023-0080Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claimsSamer Haidar0https://orcid.org/0009-0006-5594-764XReynaldo Vazquez1https://orcid.org/0009-0009-1946-3615Goran Medic2https://orcid.org/0000-0002-2440-8743Advanced Algorithm Research Center, Philips, Cambridge, MA 02141, USAChief Medical Office, Philips, Eindhoven, 5656AG, The NetherlandsChief Medical Office, Philips, Eindhoven, 5656AG, The NetherlandsAim: To compare the length of stay, hospital costs and hospital revenues for Medicare patients with and without a subset of potentially preventable postoperative complications after major noncardiac surgery. Materials & methods: Retrospective data analysis using the Medicare Standard Analytical Files, Limited Data Set, 5% inpatient claims files for years 2016–2020. Results: In 74,103 claims selected for analysis, 71,467 claims had no complications and 2636 had one or more complications of interest. Claims with complications had significantly longer length of hospital stay (12.41 vs 3.95 days, p < 0.01), increased payments to the provider ($34,664 vs $16,641, p < 0.01) and substantially higher estimates of provider cost ($39,357 vs $16,158, p < 0.01) compared with claims without complications. This results on average in a negative difference between payments and costs for patients with complications compared with a positive difference for claims without complications (-$4693 vs $483, p < 0.01). Results were consistent across three different cost estimation methods used in the study. Conclusion: Compared with patients without postoperative complications, patients developing complications stay longer in the hospital and incur increased costs that outpace the increase in received payments. Complications are therefore costly to providers and payers, may negatively impact hospital profitability, and decrease the quality of life of patients. Quality initiatives aimed at reducing complications can be immensely valuable for both improving patient outcomes and hospital finances.health economicshospital financespostoperative complicationsretrospective studiessurgical quality |
| spellingShingle | Samer Haidar Reynaldo Vazquez Goran Medic Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims Journal of Comparative Effectiveness Research health economics hospital finances postoperative complications retrospective studies surgical quality |
| title | Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims |
| title_full | Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims |
| title_fullStr | Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims |
| title_full_unstemmed | Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims |
| title_short | Impact of surgical complications on hospital costs and revenues: retrospective database study of Medicare claims |
| title_sort | impact of surgical complications on hospital costs and revenues retrospective database study of medicare claims |
| topic | health economics hospital finances postoperative complications retrospective studies surgical quality |
| work_keys_str_mv | AT samerhaidar impactofsurgicalcomplicationsonhospitalcostsandrevenuesretrospectivedatabasestudyofmedicareclaims AT reynaldovazquez impactofsurgicalcomplicationsonhospitalcostsandrevenuesretrospectivedatabasestudyofmedicareclaims AT goranmedic impactofsurgicalcomplicationsonhospitalcostsandrevenuesretrospectivedatabasestudyofmedicareclaims |