Literature DB >> 27554623

Variation in inpatient hospital and physician payments among patients undergoing general versus orthopedic operations.

Aslam Ejaz1, Faiz Gani2, Yuhree Kim2, Timothy M Pawlik3.   

Abstract

BACKGROUND: Comparative data on surgeon payments for operative procedures are not well documented. We sought to assess variations in surgeon payments after common general and orthopedic operations using a nationally representative sample of privately insured patients.
METHODS: A total of 486,506 patients who underwent a general (appendectomy, cholecystectomy, colectomy) or orthopedic (total knee replacement, total hip replacement) operation between 2010-2012 were identified from the Truven Health MarketScan database.
RESULTS: Median age was 54 years (general operation, 44 years vs orthopedic operation, 58 years; P < .001). Patients had an average Charlson Comorbidity Index of 0 (interquartile range [IQR]: 0, 1). Median duration of stay was 3 days (IQR: 2, 4) (general operation, 3 days [IQR: 1, 5] vs orthopedic operation, 3 days [IQR: 2, 3]; P < .001). Total hospital payments averaged $18,209 (IQR: $11,751, $26,598) (general operation: $12,744 [IQR: $8,402, $19,896] vs orthopedic operation: $22,386 [IQR: $16,888, $30,100]; P < .001). Median surgeon reimbursement was $1,923 (IQR: $1,146, $2,676), with orthopedic surgeon payments being on average twice as high as general surgeon payments ($2,349 vs $1,191; P < .001). Median surgeon payment varied among both general (appendectomy: $903 vs cholecystectomy: $1,125 vs colectomy: $2,209; P < .001) and orthopedic operations (total knee replacement: $2,282 vs total hip replacement: $2,392; P < .001). The presence of a postoperative complication resulted in an increase in hospital payments by 25% and surgeon payments by 11%.
CONCLUSIONS: Hospital and surgeon payments following routine general and orthopedic operations vary greatly. Patients with comorbid conditions and those who experienced a postoperative complication resulted in higher overall payments. Though significant variability existed at the surgeon level, hospital payments were responsible for the highest source of variability.
Copyright © 2016 Elsevier Inc. All rights reserved.

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Year:  2016        PMID: 27554623     DOI: 10.1016/j.surg.2016.07.013

Source DB:  PubMed          Journal:  Surgery        ISSN: 0039-6060            Impact factor:   3.982


  1 in total

1.  Variation in Physician-Specific Episode Payments for Major Cancer Surgery and Implications for the Merit-Based Incentive Program.

Authors:  Deborah R Kaye; Rodney L Dunn; Jonathan Li; Lindsey A Herrel; James M Dupree; David C Miller; Chad Ellimoottil
Journal:  J Surg Res       Date:  2018-12-04       Impact factor: 2.192

  1 in total

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