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Comparative effectiveness and efficiency in peripheral vascular surgery

Fry, Donald E., M.D ; Pine, Michael, M.D., M.B.A ; Jones, Barbara L., M.A ; Meimban, Roger J., Ph.D

The American journal of surgery, 2011-03, Vol.201 (3), p.363-368 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Comparative effectiveness and efficiency in peripheral vascular surgery
Autor: Fry, Donald E., M.D ; Pine, Michael, M.D., M.B.A ; Jones, Barbara L., M.A ; Meimban, Roger J., Ph.D
Assuntos: Adult ; Adverse outcomes ; Aged ; Aneurysms ; Aorta ; Aortic Aneurysm - surgery ; Aortic aneurysms ; Biological and medical sciences ; Bypasses ; Carotid endarterectomy ; Comorbidity ; Comparative effectiveness ; Comparative Effectiveness Research ; Complications ; Cost analysis ; Cost-Benefit Analysis ; Efficiency ; Elective Surgical Procedures - economics ; Endarterectomy, Carotid - economics ; Female ; Femoral Artery - surgery ; Femur ; General aspects ; Health care ; Health Care Costs ; Hospital Costs ; Hospitals ; Humans ; Maintenance ; Male ; Medical sciences ; Middle Aged ; Morbidity ; Patients ; Peripheral Vascular Diseases - economics ; Peripheral Vascular Diseases - surgery ; Population ; Quality standards ; Regression analysis ; Risk Adjustment ; Standard deviation ; Studies ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical outcomes ; Treatment Outcome ; United States ; Vascular Grafting - economics ; Vascular surgery ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels ; Vascular Surgical Procedures - adverse effects ; Vascular Surgical Procedures - economics ; Vascular Surgical Procedures - mortality
É parte de: The American journal of surgery, 2011-03, Vol.201 (3), p.363-368
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Abstract Background Elective peripheral vascular surgery provides quality outcomes that are of great benefit to patients, but have complications that result in severe morbidity and excessive costs. Methods We studied elective carotid endarterectomy, aortofemoral bypass/aortic aneurysm repairs, and femoral-distal bypass surgeries among hospitals(N ≥ 20 cases) from 2002 to 2005 from the national Inpatient Sample of the Healthcare Cost and Utilization project. Adverse outcomes, mortality, and cost models were developed. Outlier hospitals were defined for excessive adverse outcomes ( P < .005) and excess cost ( P < .0005). Results There were 43,700 carotid endarterectomy patients from 447 hospitals, 9,090 aortofemoral bypass/aortic aneurysm patients from 187 hospitals, and 14,453 femoral-distal bypass patients from 243 hospitals. Approximately 3% of hospitals were quality outliers, and 8% to 24% of hospitals were efficiency outliers by procedure. Conclusions Comparative effectiveness and efficiency modeling at the hospital level shows inefficiency and is responsible for 90% of excess costs. Overall reduced complication rates will further enhance cost reductions.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Comparative effectiveness and efficiency in peripheral vascular surgery

Fry, Donald E., M.D ; Pine, Michael, M.D., M.B.A ; Jones, Barbara L., M.A ; Meimban, Roger J., Ph.D

New York, NY: Elsevier Inc

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