The Michigan Value Collaborative

Helping Michigan hospitals achieve their best possible patient outcomes at the lowest reasonable cost

Tag: surgery (page 1 of 2)

Staying in the hospital too long, or not long enough?

The time a patient is hospitalized, known as the length of stay, can have a big impact on the cost of the healthcare episode as well as an effect on the readmission risk for that patient. There are many studies in the literature discussing the effect of length of stay, its effect on the readmission risk and the costs associated with the healthcare episode. A brief review of recent findings is presented here:

In one study, the authors reviewed whether the day a surgery was performed on would affect length of stay – and thus the overall episode cost. They concluded that surgeries for primary total Hip and total Knee arthroplasty performed later in the week were more likely to have an increased length of stay. Interestingly, only primary total knee arthroplasty occurring later in the week had increased total charges.

A second study reviewed the affiliation between length of stay and readmission risk for total joint arthroplasty, and concluded that an increased length of stay was associated with a higher risk for a 90-day readmission. 

Another study looked at patients undergoing colorectal surgery, and discussed the benefits of an enhanced recovery program to help shorten the length of stay while also helping to reduce the readmission rates. They found that within length of the study, they were able to reduce the median length of stay and readmission rates through the development and implementation of an enhanced recovery program.

Finally a recent study performed by Dr. Scott Regenbogen (MVC co-director) and colleagues looked at whether discharge protocols and shorter lengths of stays decreased overall episode costs, or if there were post discharge costs involved that unintentionally increased costs. This study concluded that hospitals able to reduce postoperative length of stays in colorectal, CABG, and total hip replacement service lines were consistently able to reduce payments for the surgical episode.


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Johns Hopkins to share Enhanced Recovery Program with 750 other hospitals

The Armstrong Institute for Patient Safety and Quality at John’s Hopkins recently began an initiative to disseminate Enhanced Recovery practice for five common types of surgery to 750 hospitals across the country.  Partnering with the American College of Surgeons, the Institute hopes to use their data alongside with previous European data to help American hospitals see its success and importance. Johns Hopkins has already experienced the protocol’s many benefits, such as shorter lengths of stay and a reduction in cost and complication rates, and they wish to share their efforts in the hopes of improving surgical care and patient outcomes hospitals nationwide. To read the entire article, follow the link below:

http://www.baltimoresun.com/health/blog/bs-hs-surgical-safety-20170206-story.html

The MVC Coordinating Center


Questions or comments? We’d love to hear from you!  You can comment on this article, or use the form at the bottom of the page

 

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