Editor's Note In this study, bariatric surgery for obese adolescents was shown to be cost-effective if assessed over a time period of 5 years, but not in shorter time frames. The incremental cost-effectiveness ratio of bariatric surgery vs no surgery was $155,000 per quality-adjusted life year (QALY) when assessed over…

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Editor's Note A study presented at the 2016 American Orthopaedic Foot and Ankle Surgeons Annual Meeting found that total ankle replacements performed in ambulatory surgical centers (ASCs) were about $4,000 less than those performed in inpatient facilities, the October Orthopedics Today reports. The 4-year study included 574 total ankle replacements…

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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…

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Editor's Note Suboptimal postoperative outcomes are the primary driver of high overall costs of care after bariatric surgical procedures, this study finds. The study included morbidly obese patients who underwent laparoscopic vertical sleeve gastrectomy (74 patients) or laparoscopic Roux-en-Y gastric bypass (270 patients) at a single institution from 2010 to…

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Editor's Note Comparing the Comprehensive Care for Joint Replacement (CJR) program’s broad definition of a patient’s episode of care (ie, initial hospitalization until 90 days after discharge) with a clinically narrow definition of an episode of care, researchers found that hospital performance was consistent no matter which definition was used.…

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Editor's Note In the first 21 months of the Bundled Payments for Care Improvement (BPCI) initiative for total hips and knees, Medicare payments declined more for BPCI participating hospitals than nonparticipating hospitals, without a significant change in quality outcomes, this study finds. For the analysis, 31,700 total joints at 176…

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Government and third-party payers are pushing for value-based, rather than volume-based, models of care, yet few hospitals are moving that direction, a survey shows. The Centers for Medicare & Medicaid Services (CMS) requires that half of hospitals’ payments be value based by 2018, according to a 2016 Health Catalyst survey…

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Editor's Note In this study of patients discharged from two tertiary-quaternary hospitals and one community hospital, researchers found no appreciable or consistent improvement in hospital-acquired infections (HAIs), mortality, or length of stay from 2006 and 2012. During this time, total charges declined by 11% for bloodstream infection and 13% for…

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Editor's Note This study found that hospital-acquired pressure ulcers add 44% to the cost of major surgical hospital stays, but the amount varies depending on length of stay. Using data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and the Medicare Patient Safety Monitoring System for 2011…

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Editor's Note Appendectomy is cost-effective for abscessed appendicitis in patients less than 34 years old, this study finds. For an 18-year-old patient, appendectomy costs $9,417.22 with a gain of 16.59 quality-adjusted life years (QALYs), compared with no appendectomy, which costs $11,613.57 with a gain of 16.52 QALYs. For a 35-year-old…

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