Variation in Medicare expenditures for surgical complications

Editor's Note

In this study, substantial variation was observed across hospitals in Medicare episode payments for patients rescued from surgical complications, and higher payments were not associated with improved clinical performance.

Medicare payments for patients rescued at the highest-cost hospitals were two- to threefold higher than the lowest-cost hospitals for abdominal aortic aneurysm repair ($60,456 vs $23,261), colectomy ($56,787 vs $22,853), pulmonary resection ($63,117 vs $21,325), and total hip ($41,354 vs $19,028).

Compared with lowest-cost, highest-cost hospitals had higher rates of serious complications with similar rates of failure to rescue and 30-day mortality.

The findings highlight the potential for hospitals to examine strategies for managing surgical complications to identify opportunities for improved cost efficiency, the researchers note.

Importance Treating surgical complications presents a major challenge for hospitals striving to deliver high-quality care while reducing costs. Costs associated with rescuing patients from perioperative complications are poorly characterized. Objective To evaluate differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery.