Excess Costs Attributable to Postoperative Complications
This article estimates excess costs associated with postoperative complications among inpatients treated in Veterans Health Administration (VA) hospitals. The authors conducted an observational study on 43,822 hospitalizations involving inpatient surgery in one of 104 VA hospitals during fiscal year...
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| Veröffentlicht in: | Medical care research and review 2011-08, Vol.68 (4), p.490-503 |
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| creator | Carey, Kathleen Stefos, Theodore Shibei Zhao Borzecki, Ann M. Rosen, Amy K. |
| description | This article estimates excess costs associated with postoperative complications among inpatients treated in Veterans Health Administration (VA) hospitals. The authors conducted an observational study on 43,822 hospitalizations involving inpatient surgery in one of 104 VA hospitals during fiscal year 2007. Hospitalization-level cost regression analyses were performed to estimate the excess cost of each of 18 unique postoperative complications. The authors used generalized linear modeling techniques to account for the heavily skewed cost distribution. Costs were measured using an activity-based cost accounting system and complications were assessed based on medical chart review conducted by the VA ‘National Surgical Quality Improvement Program. The authors found excess costs associated with postoperative complications ranging from $8,338 for “superficial surgical site infection” to $29,595 for “failure to wean within 24 hours in the presence of respiratory complications.” The results obtained suggest that quality improvement efforts aimed at reducing postoperative complications can contribute significantly to lowering of hospital costs. |
| doi_str_mv | 10.1177/1077558710396378 |
| format | Article |
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The authors conducted an observational study on 43,822 hospitalizations involving inpatient surgery in one of 104 VA hospitals during fiscal year 2007. Hospitalization-level cost regression analyses were performed to estimate the excess cost of each of 18 unique postoperative complications. The authors used generalized linear modeling techniques to account for the heavily skewed cost distribution. Costs were measured using an activity-based cost accounting system and complications were assessed based on medical chart review conducted by the VA ‘National Surgical Quality Improvement Program. The authors found excess costs associated with postoperative complications ranging from $8,338 for “superficial surgical site infection” to $29,595 for “failure to wean within 24 hours in the presence of respiratory complications.” The results obtained suggest that quality improvement efforts aimed at reducing postoperative complications can contribute significantly to lowering of hospital costs.</description><identifier>ISSN: 1077-5587</identifier><identifier>EISSN: 1552-6801</identifier><identifier>DOI: 10.1177/1077558710396378</identifier><identifier>PMID: 21536599</identifier><identifier>CODEN: MCRRFH</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Accounting ; Adolescent ; Adult ; Aged ; Chart reviews ; Child ; Complications ; Cost accounting ; Cost analysis ; Costs ; Distribution costs ; Female ; Health costs ; Hospital costs ; Hospital Costs - statistics & numerical data ; Hospitalization ; Hospitals ; Hospitals, Veterans - economics ; Hospitals, Veterans - statistics & numerical data ; Humans ; Infections ; Linear analysis ; Male ; Middle Aged ; Military hospitals ; Postoperative Complications - economics ; Postoperative morbidity ; Quality control ; Quality management ; Regression analysis ; Skewed distributions ; Surgery ; United States ; United States Department of Veterans Affairs - economics ; Veterans ; Weaning ; Young Adult</subject><ispartof>Medical care research and review, 2011-08, Vol.68 (4), p.490-503</ispartof><rights>The Author(s) 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-f827d7b7fa0d8ca1869ecba27e6d916b95f7acfc7dac297d4b5cbe07d684c9d03</citedby><cites>FETCH-LOGICAL-c396t-f827d7b7fa0d8ca1869ecba27e6d916b95f7acfc7dac297d4b5cbe07d684c9d03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1077558710396378$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1077558710396378$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,30976,30977,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21536599$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carey, Kathleen</creatorcontrib><creatorcontrib>Stefos, Theodore</creatorcontrib><creatorcontrib>Shibei Zhao</creatorcontrib><creatorcontrib>Borzecki, Ann M.</creatorcontrib><creatorcontrib>Rosen, Amy K.</creatorcontrib><title>Excess Costs Attributable to Postoperative Complications</title><title>Medical care research and review</title><addtitle>Med Care Res Rev</addtitle><description>This article estimates excess costs associated with postoperative complications among inpatients treated in Veterans Health Administration (VA) hospitals. The authors conducted an observational study on 43,822 hospitalizations involving inpatient surgery in one of 104 VA hospitals during fiscal year 2007. Hospitalization-level cost regression analyses were performed to estimate the excess cost of each of 18 unique postoperative complications. The authors used generalized linear modeling techniques to account for the heavily skewed cost distribution. Costs were measured using an activity-based cost accounting system and complications were assessed based on medical chart review conducted by the VA ‘National Surgical Quality Improvement Program. The authors found excess costs associated with postoperative complications ranging from $8,338 for “superficial surgical site infection” to $29,595 for “failure to wean within 24 hours in the presence of respiratory complications.” The results obtained suggest that quality improvement efforts aimed at reducing postoperative complications can contribute significantly to lowering of hospital costs.</description><subject>Accounting</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Chart reviews</subject><subject>Child</subject><subject>Complications</subject><subject>Cost accounting</subject><subject>Cost analysis</subject><subject>Costs</subject><subject>Distribution costs</subject><subject>Female</subject><subject>Health costs</subject><subject>Hospital costs</subject><subject>Hospital Costs - statistics & numerical data</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Hospitals, Veterans - economics</subject><subject>Hospitals, Veterans - statistics & numerical data</subject><subject>Humans</subject><subject>Infections</subject><subject>Linear analysis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Military hospitals</subject><subject>Postoperative Complications - economics</subject><subject>Postoperative morbidity</subject><subject>Quality control</subject><subject>Quality management</subject><subject>Regression analysis</subject><subject>Skewed distributions</subject><subject>Surgery</subject><subject>United States</subject><subject>United States Department of Veterans Affairs - economics</subject><subject>Veterans</subject><subject>Weaning</subject><subject>Young Adult</subject><issn>1077-5587</issn><issn>1552-6801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkM1LAzEQxYMotlbvnmTBg6fVSdJ8HUupH1DQg56XJJuVLbvNusmK_vemtIoUxFMmeb95k3kInWO4xliIGwxCMCYFBqo4FfIAjTFjJOcS8GGqk5xv9BE6CWEFAFMi6TEaEcwoZ0qNkVx8WBdCNvchhmwWY1-bIWrTuCz67Cm9-s71OtbvLjFt19Q2Xfw6nKKjSjfBne3OCXq5XTzP7_Pl493DfLbMbfpSzCtJRCmMqDSU0mosuXLWaCIcLxXmRrFKaFtZUWpLlCinhlnjQJRcTq0qgU7Q1da36_3b4EIs2jpY1zR67fwQCgUEFJeK_ktKiUEqBiqRl3vkyg_9Oq1RYEUkoQAUJwq2lO19CL2riq6vW91_FhiKTfzFfvyp5WJnPJjWlT8N33knIN8CQb-6X1P_MvwCacSMPQ</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>Carey, Kathleen</creator><creator>Stefos, Theodore</creator><creator>Shibei Zhao</creator><creator>Borzecki, Ann M.</creator><creator>Rosen, Amy K.</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201108</creationdate><title>Excess Costs Attributable to Postoperative Complications</title><author>Carey, Kathleen ; Stefos, Theodore ; Shibei Zhao ; Borzecki, Ann M. ; Rosen, Amy K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-f827d7b7fa0d8ca1869ecba27e6d916b95f7acfc7dac297d4b5cbe07d684c9d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Accounting</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Chart reviews</topic><topic>Child</topic><topic>Complications</topic><topic>Cost accounting</topic><topic>Cost analysis</topic><topic>Costs</topic><topic>Distribution costs</topic><topic>Female</topic><topic>Health costs</topic><topic>Hospital costs</topic><topic>Hospital Costs - statistics & numerical data</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Hospitals, Veterans - economics</topic><topic>Hospitals, Veterans - statistics & numerical data</topic><topic>Humans</topic><topic>Infections</topic><topic>Linear analysis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Military hospitals</topic><topic>Postoperative Complications - economics</topic><topic>Postoperative morbidity</topic><topic>Quality control</topic><topic>Quality management</topic><topic>Regression analysis</topic><topic>Skewed distributions</topic><topic>Surgery</topic><topic>United States</topic><topic>United States Department of Veterans Affairs - economics</topic><topic>Veterans</topic><topic>Weaning</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carey, Kathleen</creatorcontrib><creatorcontrib>Stefos, Theodore</creatorcontrib><creatorcontrib>Shibei Zhao</creatorcontrib><creatorcontrib>Borzecki, Ann M.</creatorcontrib><creatorcontrib>Rosen, Amy K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Medical care research and review</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carey, Kathleen</au><au>Stefos, Theodore</au><au>Shibei Zhao</au><au>Borzecki, Ann M.</au><au>Rosen, Amy K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Excess Costs Attributable to Postoperative Complications</atitle><jtitle>Medical care research and review</jtitle><addtitle>Med Care Res Rev</addtitle><date>2011-08</date><risdate>2011</risdate><volume>68</volume><issue>4</issue><spage>490</spage><epage>503</epage><pages>490-503</pages><issn>1077-5587</issn><eissn>1552-6801</eissn><coden>MCRRFH</coden><abstract>This article estimates excess costs associated with postoperative complications among inpatients treated in Veterans Health Administration (VA) hospitals. The authors conducted an observational study on 43,822 hospitalizations involving inpatient surgery in one of 104 VA hospitals during fiscal year 2007. Hospitalization-level cost regression analyses were performed to estimate the excess cost of each of 18 unique postoperative complications. The authors used generalized linear modeling techniques to account for the heavily skewed cost distribution. Costs were measured using an activity-based cost accounting system and complications were assessed based on medical chart review conducted by the VA ‘National Surgical Quality Improvement Program. The authors found excess costs associated with postoperative complications ranging from $8,338 for “superficial surgical site infection” to $29,595 for “failure to wean within 24 hours in the presence of respiratory complications.” The results obtained suggest that quality improvement efforts aimed at reducing postoperative complications can contribute significantly to lowering of hospital costs.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>21536599</pmid><doi>10.1177/1077558710396378</doi><tpages>14</tpages></addata></record> |
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| subjects | Accounting Adolescent Adult Aged Chart reviews Child Complications Cost accounting Cost analysis Costs Distribution costs Female Health costs Hospital costs Hospital Costs - statistics & numerical data Hospitalization Hospitals Hospitals, Veterans - economics Hospitals, Veterans - statistics & numerical data Humans Infections Linear analysis Male Middle Aged Military hospitals Postoperative Complications - economics Postoperative morbidity Quality control Quality management Regression analysis Skewed distributions Surgery United States United States Department of Veterans Affairs - economics Veterans Weaning Young Adult |
| title | Excess Costs Attributable to Postoperative Complications |
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