Who Pays for Poor Surgical Quality? Building a Business Case for Quality Improvement

Dimick, Justin B.; Weeks, William B.; Karia, Raj; Das, Smita; Campbell, Darrell A.

doi:10.1016/j.jamcollsurg.2006.02.015

Cited by 181 publications

(110 citation statements)

References 15 publications

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“…[1,4,7] Further, surgical care is particularly expensive in the setting of postoperative morbidity, where longer hospital stays and high resource utilization are common. [18,19] Previous work using national survey data indicated high costs attributed to treating sarcopenic elderly patients, though analyses lacked objective metrics for assessing musculature. [20] Methods for controlling cost in surgery (e.g.…”

Section: Discussionmentioning

confidence: 99%

The cost of major surgery in the sarcopenic patient

Sheetz¹,

Waits²,

Terjimanian³

et al. 2013

Journal of the American College of Surgeons

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Section: Discussionmentioning

confidence: 99%

The cost of major surgery in the sarcopenic patient

Sheetz¹,

Waits²,

Terjimanian³

et al. 2013

Journal of the American College of Surgeons

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“…4 These complications substantially increase the costs of surgical care for both hospitals and payors. 6,7 Beyond the clinical consequences, however, many patients with cancer also suffer significant economic hardship from their disease and its treatment. [8][9][10][11] Even among those with medical insurance, cancer therapies may require substantial out-of-pocket expenditures for medications, copayments for diagnostic testing, hospital and outpatient care, travel, and home care.…”

Section: Introductionmentioning

confidence: 99%

The personal financial burden of complications after colorectal cancer surgery

Regenbogen

Veenstra

Hawley

et al. 2014

Cancer

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BACKGROUND:Patients with colorectal cancer (CRC) may suffer significant economic hardship during treatment. Complications are common after surgery for CRC and may exacerbate the financial burden of CRC even further. METHODS: Within a population-based survey of patients with stage III CRC, the authors investigated the effects of disease and treatment on personal finances and computed a composite measure of financial burden. Correlations were examined between components of financial burden and patientreported postoperative complications using chi-square analyses, and Mantel-Haenszel chi-square tend tests were used to evaluate correlations between composite financial burden scores and surgical complications, controlling for patient characteristics and other factors by using multivariable Poisson regression. RESULTS: Among 937 respondents, 224 (24%) reported complications after surgery. Those with complications had significantly higher composite financial burden (P <.001 for trend): they were more likely to spend savings (40% vs 31%; P 5.01), borrow or take loans (18% vs 11%; P 5.007), fail to make credit card payments (18% vs 11%; P 5.005), reduce spending for food or clothes (38% vs 27%; P 5.001), and decrease recreational activities (41% vs 33%; P 5.03). They took significantly longer to return to work (P 5.009) and were more likely to experience significant worry about finances (61% vs 52%; P 5.01). CONCLUSIONS: Complications after surgery for CRC result in significant personal financial consequences as well as morbidity. Financial stress impairs quality of life and may prevent adherence to recommended treatments. Therefore, patients who suffer complications may require not just additional clinical care but also economic support and services. Cancer 2014;120:3074-81.

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“…We owe it to these patients to do the best we can, not only because a civilised society should look after its elderly [8], but because it makes sense. The costs of less than optimal care are high [9], most importantly for the patient, but also in terms of [1,5,[7][8][9]. In the past 10 years, there has been a massive injection of resources into non-urgent surgery [10], resulting in improved access to hospital for elective patients.…”

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confidence: 99%

Emergency surgery in the elderly patient: a quality improvement approach

Peden¹

2011

Anaesthesia

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Who Pays for Poor Surgical Quality? Building a Business Case for Quality Improvement

Cited by 181 publications

References 15 publications

The cost of major surgery in the sarcopenic patient

The cost of major surgery in the sarcopenic patient

The personal financial burden of complications after colorectal cancer surgery

Emergency surgery in the elderly patient: a quality improvement approach

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