TY - JOUR
T1 - Hospital charge and health-care quality in bariatric surgery
AU - Telem, Dana A.
AU - Yang, Jie
AU - Altieri, Maria
AU - Talamini, Mark
AU - Zhang, Qiao
AU - Pryor, Aurora D.
PY - 2017/2
Y1 - 2017/2
N2 - To determine if hospital charges correlate with patient outcomes after bariatric surgery.Aretrospective review of 46,180 patients who underwent bariatric surgery from 2004-2010 was performed. Patients were identified using the New York Statewide Planning and Research Cooperative System database. Hospitals were categorized on estimates from a multiple linear regression model for charge: low (<$25,027.00),medium ($25,027.00-$35,449.00), and high (≥$35,449.01). Patient outcomes were compared among the charge classification. Of the 46,180 patients, 24 per cent underwent operations in low-, 26 per cent inmedium-, and 23,082 (50%) in high-charge hospitals. Controlling for patient demographics, comorbidity, insurance, and operative procedure, multivariable logistic regression demonstrated no significant difference in major complication or mortality among charges. Hospital charge does not correlate with improved outcomes. This is significant given the adverse association between price inflation and rising insurance premiums. Inflated hospital charges may also discriminate against certain patient populations including the uninsured and those with high-deductible insurance plans.
AB - To determine if hospital charges correlate with patient outcomes after bariatric surgery.Aretrospective review of 46,180 patients who underwent bariatric surgery from 2004-2010 was performed. Patients were identified using the New York Statewide Planning and Research Cooperative System database. Hospitals were categorized on estimates from a multiple linear regression model for charge: low (<$25,027.00),medium ($25,027.00-$35,449.00), and high (≥$35,449.01). Patient outcomes were compared among the charge classification. Of the 46,180 patients, 24 per cent underwent operations in low-, 26 per cent inmedium-, and 23,082 (50%) in high-charge hospitals. Controlling for patient demographics, comorbidity, insurance, and operative procedure, multivariable logistic regression demonstrated no significant difference in major complication or mortality among charges. Hospital charge does not correlate with improved outcomes. This is significant given the adverse association between price inflation and rising insurance premiums. Inflated hospital charges may also discriminate against certain patient populations including the uninsured and those with high-deductible insurance plans.
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M3 - Article
C2 - 28228204
AN - SCOPUS:85015600475
SN - 0003-1348
VL - 83
SP - 170
EP - 175
JO - American Surgeon
JF - American Surgeon
IS - 2
ER -