...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of the American College of Surgeons >Who pays for poor surgical quality? Building a business case for quality improvement.
【24h】

Who pays for poor surgical quality? Building a business case for quality improvement.

机译：谁为糟糕的手术质量买单？建立业务案例以提高质量。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Both providers and payors bear the financial risk associated with complications of poor quality care. But the stakeholder who bears the largest burden of this risk has a strong incentive to support quality improvement activities. The goal of the present study was to determine whether hospitals or payors incur a larger burden of increased hospital costs associated with complications. STUDY DESIGN: We merged clinical data for 1,008 surgical patients from the private sector National Surgical Quality Improvement Program to the internal cost-accounting database of a large university hospital. We then determined the marginal costs of surgical complications from the perspective of both hospitals (changes in profit and profit margin) and payors (increase in reimbursement paid to the hospital). In our analyses of cost and reimbursement, we adjusted for procedure complexity and patient characteristics using multivariate linear regression. RESULTS: Reimbursement for patients without complications (Dollars 14,266) exceeded hospital costs (Dollars 10,978), generating an average hospital profit of Dollars 3,288 and a profit margin of 23%. When complications occurred, hospitals still received reimbursement in excess of their costs, but the profit margin declined: reimbursement (Dollars 21,911) exceeded hospital costs (Dollars 21,156), yielding an average profit of Dollars 755 and a profit margin of 3.4%. Complications were always associated with an increase in costs to health-care payors: complications were associated with an average increase in reimbursement of Dollars 7,645 (54%) per patient. CONCLUSIONS: Hospitals and payors both suffer financial consequences from poor-quality health care, but the greater burden falls on health-care payors. Strong incentives exist for health-care payors to become more involved in supporting quality improvement activities.
机译：背景：提供者和付款人都承担与低质量护理并发症相关的财务风险。但是承担最大风险的利益相关者有强烈的动机支持质量改进活动。本研究的目的是确定医院或付款人是否承担与并发症相关的医院费用增加的较大负担。研究设计：我们将来自私营部门“国家外科质量改善计划”的1,008名外科患者的临床数据合并到一家大型大学医院的内部成本核算数据库中。然后，我们从医院（利润和利润率的变化）和付款人（支付给医院的报销增加）的角度确定了手术并发症的边际成本。在成本和报销分析中，我们使用多元线性回归对程序复杂性和患者特征进行了调整。结果：没有并发症的患者的报销（14,266美元）超出了医院的费用（10,978美元），平均住院利润为3,288美元，利润率为23％。当发生并发症时，医院仍会收到超出其费用的报销额，但利润率下降：报销额（21,911美元）超过了医院费用（21,156美元），产生的平均利润为755美元，利润率为3.4％。并发症总是与卫生保健付款人的费用增加有关：并发症与每位患者平均报销7,645美元（54％）有关。结论：医院和付款人都因医疗质量低劣而遭受财务后果，但更大的负担落在了医疗付款人身上。存在强烈的激励措施，要求卫生保健付款人更多地参与支持质量改进活动。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号