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Reducing cost drivers in total joint arthroplasty: understanding patient readmission risk and supply cost

机译：减少总关节置换术中的成本驱动因素：了解患者的再次入院风险和供应成本

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摘要

Introduction: Understanding and planning for the factors that impact supply cost and unplanned readmission risk for total joint arthroplasty (TJA) patients is helpful for hospitals at financial risk under bundled payments. Readmission and operating room supply costs are two of the biggest expenses. Methods: Logistic and linear regressions are used to measure the impacts of TJA patient attributes on readmission risk and supply costs, respectively. Results: Patients' health market segment and the number/type of comorbidity impacts 30/90-day readmission rates. Surgeon implant preference and type of surgery impact supply costs. Discharge location and two of the five health market segments increase the odds of 30-day readmission. Arrhythmia and lymphoma are the primary comorbidities that impact the odds of readmission at 90 days. Conclusions: Preoperatively identifying TJA patients likely to have large supply costs and higher readmission risk allows hospitals to invest in low-cost interventions to reduce risk and improve healthcare value.
机译：简介：了解和计划影响全关节置换术（TJA）患者的供应成本和计划外再入院风险的因素，对于在捆绑付款下处于财务风险的医院很有帮助。再入院和手术室供应成本是最大的两项支出。方法：逻辑回归和线性回归分别用于衡量TJA患者属性对再入院风险和供应成本的影响。结果：患者的医疗市场细分和合并症的数量/类型影响30/90天的再入院率。外科医生的植入物偏好和手术类型会影响供应成本。出院地点和五个健康市场细分市场中的两个增加了30天再次入院的机会。心律失常和淋巴瘤是影响90天再入院几率的主要合并症。结论：术前确定可能有高昂的供应成本和更高的再入院风险的TJA患者，使医院可以投资于低成本的干预措施，以降低风险并提高医疗保健价值。

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  • 来源
    《Health system》 |2018年第2期|135-147|共13页
  • 作者

    Eric R. Swenson; Nathaniel D. Bastian; Harriet B. Nembhard; Charles M. Davis lll;

  • 作者单位

    Center for Health Organization Transformation, Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA, USA;

    Center for Health Organization Transformation, Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA, USA;

    Center for Health Organization Transformation, Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA, USA;

    Penn State Hershey Medical Center, Bone and Joint Institute, Hershey, PA, USA;

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  • 原文格式 PDF
  • 正文语种 eng
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  • 关键词

    Total joint arthroplasty; readmission risk; supply cost; health market segmentation; regression modelling;

    机译：全关节置换术再入院风险;供应成本;卫生市场细分;回归建模;

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