Hospital costs associated with surgical complications: A report from the private-sector national surgical quality improvement program
Hospital costs associated with surgical complications: A report from the private-sector national surgical quality improvement program
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DOI：
10.1016/j.jamcollsurg.2004.05.276
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发表时间：
2004-10-01
影响因子：
5.2
通讯作者：
Campbell, DA
中科院分区：
文献类型：
--
作者：
Dimick, JB;Chen, SL;Campbell, DA
背景：国家外科质量改进项目（NSQIP）降低了退伍军人事务医院的发病率。随着NSQIP方法转移到私营医院，资金责任将转移到医疗中心。本研究的目的是计算与术后并发症相关的住院费用，因为降低发病率可能会抵消使用NSQIP.Study设计的成本：患者数据来自2001年至2002年参与NSQIP的一个私营部门中心（n = 1,008）。成本数据来自医院的内部成本核算数据库（TSI;全视线系统公司）。计算与轻微并发症和严重并发症相关的总住院费用。多元线性回归用于确定调整患者特征后的每种类型的并发症的成本。结果：轻微并发症（6.3%，64起事件）和严重并发症（6.6%，67起事件）的发生率相似。无并发症患者的中位住院费用最低（4，487美元），与轻微并发症（14，094美元）和严重并发症（28，356美元）相比（p < 0.001）。在调整患者特征差异后，严重并发症与11，626美元的增加相关（95% CI，9，419美元至13，832美元; p < 0.001）。轻微的并发症与调整后的analysis.CONCLUSIONS：鉴于重大术后并发症相关的大量费用，降低发病率可能提供足够的成本节约，以抵消所需的资源，参与私营部门扩大NSQIP。(C)2004年由美国外科医生学会。
BACKGROUND: The National Surgical Quality Improvement Project (NSQIP) has reduced morbidity rates in Veterans Affairs Hospitals. As the NSQIP methods move to private-sector hospitals, funding responsibilities will shift to the medical center. The objective of the current study was to calculate hospital costs associated with postoperative complications, because reducing morbidity may offset the costs of using the NSQIP.STUDY DESIGN: Patient data were obtained from a single private-sector center involved in the NSQIP from 2001 to 2002 (n = 1,008). Cost data were derived from the hospital's internal cost-accounting database (TSI; Transitions Systems Inc). Total hospital costs associated with both minor complications and major complications were calculated. Multiple linear regression was used to determine the cost of each type of complication after adjusting for patient characteristics.RESULTS: Rates of minor complications (6.3%, 64 events) and major complications (6.6%, 67 events) were similar. Median hospital costs were lowest for patients without complications ($4,487) compared with those with minor ($14,094) and major complications ($28,356) (p < 0.001). After adjusting for differences in patient characteristics, major complications were associated with an increase of $11,626 (95% CI, $9,419 to $13,832; p < 0.001). Minor complications were not associated with increased costs in the adjusted analysis.CONCLUSIONS: Given the substantial costs associated with major postoperative complications, reducing morbidity may provide sufficient cost savings to offset the resources needed to participate in the private-sector expansion of the NSQIP. (C) 2004 by the American College of Surgeons.