当前位置： SCI文献检索 > SURGERY期刊下所有文献 > Real money: complications and hospital costs in trauma patients.

Real money: complications and hospital costs in trauma patients.

Abstract：

BACKGROUND:Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We used the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, duration of stay, and payment associated with complications in trauma patients. METHODS:Using NSQIP principles, patient data were collected for 512 adult patients admitted to the trauma service for > 24 hours at a Level 1 trauma center (2004-2005). Patients were placed in 1 of 3 groups: no complications (none), >or=1 minor complication (minor, eg, urinary tract infection), or >or=1 major complication (major, eg, pneumonia). Total hospital charges, costs, payment, and duration of stay associated with each complication group were determined from a cost-accounting database. Multiple regression was used to determine the costs of each type of complication after adjusting for differences in age, sex, new injury severity score, Glasgow coma scale score, maximum head abbreviated injury scale, and first emergency department systolic blood pressure. RESULTS:A total of 330 (64%) patients had no complications, 53 (10%) had >or= 1 minor complication, and 129 (25%) had >or= 1 major complication. Median hospital charges increased from $33,833 (none) to $81,936 (minor) and $150,885 (major). The mean contribution to margin per day was similar for the no complication and minor complication groups ($994 vs $1,115, P = .7). Despite higher costs, the patients in the major complication group generated a higher mean contribution to margin per day compared to the no complication group ($2,168, P < .001). The attributable increase in median total hospital costs when adjusted for confounding variables was $19,915 for the minor complication group (P < .001), and $40,555 for the major complication group (P < .001). CONCLUSION:Understanding the costs associated with traumatic injury provides a window for assessing the potential cost reductions associated with improved quality care. To optimize system benefits, payers and providers should develop integrated reimbursement methodologies that align incentives to provide quality care.

journal_name

Surgery

journal_title

Surgery

authors

Hemmila MR,Jakubus JL,Maggio PM,Wahl WL,Dimick JB,Campbell DA Jr,Taheri PA

doi

10.1016/j.surg.2008.05.003

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

307-16

issue

eissn

0039-6060

issn

1532-7361

pii

S0039-6060(08)00289-4

journal_volume

144

pub_type

杂志文章

在线工具

Real money: complications and hospital costs in trauma patients.