Pancreas fistula risk prediction: implications for hospital costs and payments.
HPB (Oxford)
; 19(2): 140-146, 2017 02.
Article
en En
| MEDLINE
| ID: mdl-27884544
ABSTRACT
BACKGROUND:
As payment models evolve, disease-specific risk stratification may impact patient selection and financial outcomes. This study sought to determine whether a validated clinical risk score for post-operative pancreatic fistula (POPF) could predict hospital costs, payments, and profit margins.METHODS:
A multi-institutional cohort of 1193 patients undergoing pancreaticoduodenectomy (PD) were matched to an independent hospital where cost, in US$, and payment data existed. An analytic model detailed POPF risk and post-operative sequelae, and their relationship with hospital cost and payment.RESULTS:
Per-patient hospital cost for negligible-risk patients was $37,855. Low-, moderate-, and high- risk patients had incrementally higher hospital costs of $38,125 ($270; 0.7% above negligible-risk), $41,128 ($3273; +8.6%), and $41,983 ($3858; +10.9%), respectively. Similarly, hospital payment for negligible-risk patients was $42,685/patient, with incrementally higher payments for low-risk ($43,265; +1.4%), moderate-risk ($45,439; +6.5%) and high-risk ($46,564; +9.1%) patients. The lowest 30-day readmission rates - with highest net profit - were found for negligible/low-risk patients (10.5%/11.1%), respectively, compared with readmission rates of moderate/high-risk patients (15%/15.7%).CONCLUSION:
Financial outcomes following PD can be predicted using the FRS. Such prediction may help hospitals and payers plan for resource allocation and payment matched to patient risk, while providing a benchmark for quality improvement initiatives.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Fístula Pancreática
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Evaluación de Procesos, Atención de Salud
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Pancreaticoduodenectomía
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Gastos en Salud
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Costos de Hospital
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Health_economic_evaluation
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Prognostic_studies
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Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Año:
2017
Tipo del documento:
Article