Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015

<h4>Objectives</h4> This study documents trends in risk-adjusted quality and cost for a variety of inpatient surgical procedures among Medicare beneficiaries from 2002 through 2015, which can provide valuable insight on future strategies to improve public health and health care. <h4&g...

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Autores principales:	Ning Ning, Alex Haynes, John Romley
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b08f4575464c42b58dabf163aedcf6c4
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spelling	oai:doaj.org-article:b08f4575464c42b58dabf163aedcf6c42021-11-11T07:14:45ZTrends in the quality and cost of inpatient surgical procedures in the United States, 2002–20151932-6203https://doaj.org/article/b08f4575464c42b58dabf163aedcf6c42021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8565758/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4> This study documents trends in risk-adjusted quality and cost for a variety of inpatient surgical procedures among Medicare beneficiaries from 2002 through 2015, which can provide valuable insight on future strategies to improve public health and health care. <h4>Methods</h4> We focused on 11 classes of inpatient surgery, defined by the Agency for Health Research and Quality’s (AHRQ’s) Clinical Classification System. The surgical classes studied included a wide range of surgeries, including tracheostomy, heart valve procedures, colorectal resection, and wound debridement, among others. For each surgical class, we assessed trends in treatment costs and quality outcomes, as defined by 30-day survival without unplanned readmissions, among Medicare beneficiaries receiving these procedures during hospital stays. Quality and costs were adjusted for patient severity based on demographics, comorbidities, and community context. We also explored surgical innovations of these 11 classes of inpatient surgery from 2002–2015. <h4>Results</h4> We found significant improvements in quality for 7 surgical classes, ranging from 0.08% (percutaneous transluminal coronary angioplasty) to 0.74% (heart valve procedures) per year. Changes in cost varied by surgery, the significant decrease in cost ranged from -2.59% (tracheostomy) to -0.34% (colorectal resection) per year. Treatment innovation occurred with respect to surgical procedures utilized for heart valve procedures and colorectal resection, which may be associated with the decrease in surgical cost. <h4>Conclusions</h4> Our results suggest that there was significant quality improvement for 7 surgery categories over the 14-year study period. Costs decreased significantly for 6 surgery categories, and increased significantly for 3 other categories.Ning NingAlex HaynesJohn RomleyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ning Ning Alex Haynes John Romley Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015
description	<h4>Objectives</h4> This study documents trends in risk-adjusted quality and cost for a variety of inpatient surgical procedures among Medicare beneficiaries from 2002 through 2015, which can provide valuable insight on future strategies to improve public health and health care. <h4>Methods</h4> We focused on 11 classes of inpatient surgery, defined by the Agency for Health Research and Quality’s (AHRQ’s) Clinical Classification System. The surgical classes studied included a wide range of surgeries, including tracheostomy, heart valve procedures, colorectal resection, and wound debridement, among others. For each surgical class, we assessed trends in treatment costs and quality outcomes, as defined by 30-day survival without unplanned readmissions, among Medicare beneficiaries receiving these procedures during hospital stays. Quality and costs were adjusted for patient severity based on demographics, comorbidities, and community context. We also explored surgical innovations of these 11 classes of inpatient surgery from 2002–2015. <h4>Results</h4> We found significant improvements in quality for 7 surgical classes, ranging from 0.08% (percutaneous transluminal coronary angioplasty) to 0.74% (heart valve procedures) per year. Changes in cost varied by surgery, the significant decrease in cost ranged from -2.59% (tracheostomy) to -0.34% (colorectal resection) per year. Treatment innovation occurred with respect to surgical procedures utilized for heart valve procedures and colorectal resection, which may be associated with the decrease in surgical cost. <h4>Conclusions</h4> Our results suggest that there was significant quality improvement for 7 surgery categories over the 14-year study period. Costs decreased significantly for 6 surgery categories, and increased significantly for 3 other categories.
format	article
author	Ning Ning Alex Haynes John Romley
author_facet	Ning Ning Alex Haynes John Romley
author_sort	Ning Ning
title	Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015
title_short	Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015
title_full	Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015
title_fullStr	Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015
title_full_unstemmed	Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015
title_sort	trends in the quality and cost of inpatient surgical procedures in the united states, 2002–2015
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b08f4575464c42b58dabf163aedcf6c4
work_keys_str_mv	AT ningning trendsinthequalityandcostofinpatientsurgicalproceduresintheunitedstates20022015 AT alexhaynes trendsinthequalityandcostofinpatientsurgicalproceduresintheunitedstates20022015 AT johnromley trendsinthequalityandcostofinpatientsurgicalproceduresintheunitedstates20022015
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Trends in the quality and cost of inpatient surgical procedures in the United States, 2002–2015

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