Complication reduction efforts could improve financial performance of safety-net hospitals
WEDNESDAY, April 17 (HealthDay News) -- The occurrence of surgical complications is associated with higher hospital contribution margins, which vary by payer types, according to research published in the April 17 issue of the Journal of the American Medical Association.
In an effort to determine the relationship between major surgical complications and hospital costs and revenues across four payer types, Sunil Eappen, M.D., of Harvard Medical School in Boston, and colleagues conducted a retrospective analysis of administrative records for 34,256 surgical discharges from a non-profit 12-hospital system in the United States.
According to the researchers, compared to no complications, complications generated a $39,017 (95 percent confidence interval [CI], $20,069 to $50,394) greater contribution margin per patient if the payer was a private insurer and a $1,749 (95 percent CI, $976 to $3,287) greater contribution margin per patient if the payer was Medicare. Overall, the occurrence of at least one post-surgical complication resulted in an $8,084 higher contribution margin per patient (95 percent CI, $4,903 to $9,740) and a $7,435 lower total margin per patient (95 percent CI, $5,103 to $10,507).
"Most U.S. hospitals treat patient populations primarily covered by Medicare or private payers, and programs to reduce complications may worsen their near-term financial performance," the authors write. "Some U.S. hospitals, often referred to as safety net hospitals, treat populations primarily covered by Medicaid or self-payment, and complication reduction efforts might improve their financial performance."
Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1679400#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1679400 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1679384 )