Excess Costs Attributable to Postoperative Complications
Excess Costs Attributable to Postoperative Complications
复制标题
DOI：
10.1177/1077558710396378
复制
发表时间：
2011-08-01
影响因子：
2.5
通讯作者：
Rosen, Amy K.
中科院分区：
文献类型：
--
作者：
Carey, Kathleen;Stefos, Theodore;Rosen, Amy K.
本文估计了在退伍军人健康管理局 (VA) 医院接受治疗的住院患者中与术后并发症相关的超额费用。作者对 2007 财年 104 家 VA 医院之一的 43,822 例涉及住院手术的住院患者进行了一项观察性研究。进行了住院费用回归分析，以估计 18 种独特术后并发症中每一种的超额费用。作者使用广义线性建模技术来解释严重倾斜的成本分布。使用基于活动的成本会计系统来衡量成本，并根据 VA“国家手术质量改进计划”进行的医疗图表审查来评估并发症。作者发现与术后并发症相关的超额费用从“浅表手术部位感染”的 8,338 美元到“出现呼吸系统并发症时未能在 24 小时内脱机”的 29,595 美元不等。获得的结果表明，旨在减少术后并发症的质量改进工作可以大大有助于降低医院成本。
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.