HealthDay News — According to a study published in JAMA Surgery, there is a considerable variation across hospitals in terms of Medicare payments in patients rescued from perioperative complications after major surgery.

Jason Pradarelli, MD, from Brigham and Women’s Hospital in Boston, and colleagues conducted a retrospective cohort study using claims data to assess differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery. 

Data were included for Medicare patients aged 65 to 100 years who underwent abdominal aortic aneurysm repair (69,207 patients), colectomy for cancer (107,647 patients), pulmonary resection (91,758 patients) and total hip replacement (307,399 patients).

The researchers found that for all 4 operations, patients who were rescued had higher price-standardized Medicare payments than those who died. Payments for patients who were rescued were 2- to 3-fold higher at the highest-cost-of-rescue hospitals than at the lowest cost-of-rescue hospitals for all 4 operations. 


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Highest-cost-of-rescue hospitals had higher risk-adjusted rates of serious complications than lowest-cost-of-rescue hospitals, with similar rates of failure to rescue and overall 30-day mortality.

“These findings highlight the potential for hospitals to target efficient treatment of perioperative complications in cost-reduction efforts,” the authors write.

There was 1 author who disclosed financial ties to ArborMetrix and 2 that disclosed ties to the BlueCross BlueShield of Michigan Foundation.

Reference

Pradarelli JC, Healy MA, Osborne NH, Ghaferi AA, Dimick JB and Nathan H. Variation in Medicare Expenditures for Treating Perioperative ComplicationsThe Cost of Rescue. JAMA Surg. 2016 October 7. doi:10.1001/jamasurg.2016.3340. [Epub ahead of print]

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