Determinants of Value in Coronary Artery Bypass Grafting.
Blue Cross Blue Shield Insurance Plans
/ economics
Coronary Artery Bypass
/ adverse effects
Cost-Benefit Analysis
Fee-for-Service Plans
/ economics
Health Expenditures
Hospital Costs
Humans
Length of Stay
/ economics
Medicare
/ economics
Outcome and Process Assessment, Health Care
/ economics
Patient Readmission
/ economics
Postoperative Complications
/ economics
Quality Improvement
/ economics
Quality Indicators, Health Care
/ economics
Registries
Retrospective Studies
Time Factors
Treatment Outcome
United States
coronary artery bypass
hospitalization
inpatient
length of stay
pneumonia
Journal
Circulation. Cardiovascular quality and outcomes
ISSN: 1941-7705
Titre abrégé: Circ Cardiovasc Qual Outcomes
Pays: United States
ID NLM: 101489148
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
pubmed:
13
11
2020
medline:
22
6
2021
entrez:
12
11
2020
Statut:
ppublish
Résumé
Background Over 180 000 coronary artery bypass grafting (CABG) procedures are performed annually, accounting for $7 to $10 billion in episode expenditures. Assessing tradeoffs between spending and quality contributing to value during 90-day episodes has not been conducted but is essential for success in bundled reimbursement models. We, therefore, identified determinants of variability in hospital 90-day episode value for CABG. Methods Medicare and private payor admissions for isolated CABG from 2014 to 2016 were retrospectively linked to clinical registry data for 33 nonfederal hospitals in Michigan. Hospital composite risk-adjusted complication rates (≥1 National Quality Forum-endorsed, Society of Thoracic Surgeons measure: deep sternal wound infection, renal failure, prolonged ventilation >24 hours, stroke, re-exploration, and operative mortality) and 90-day risk-adjusted, price-standardized episode payments were used to categorize hospitals by value by defining the intersection between complications and spending. Results Among 2573 total patients, those at low- versus high-value hospitals had a higher percentage of prolonged length of stay >14 days (9.3% versus 2.4%,
Identifiants
pubmed: 33176461
doi: 10.1161/CIRCOUTCOMES.119.006374
pmc: PMC8041058
mid: NIHMS1680277
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e006374Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL146619
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL076123
Pays : United States
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