Economic Impact of POI and Prolonged Length of Stay

被引:14
作者
Bosio, Raul M. [1 ]
Delaney, Conor P. [2 ,3 ]
Senagore, Anthony J. [1 ]
机构
[1] Med Univ Ohio, Dept Surg, Toledo, OH USA
[2] Univ Hosp Cleveland, Div Colorectal Surg, Cleveland, OH 44106 USA
[3] Case Western Reserve Univ, Cleveland, OH 44106 USA
关键词
ileus; cost; prolonged hospital stay; diagnosis-related group; colectomy;
D O I
10.1053/j.scrs.2006.01.012
中图分类号
R61 [外科手术学];
学科分类号
摘要
Postoperative ileus (POI) increases the duration of hospital stay and, therefore, health care costs, accounting for an estimated $ 750 million in 1986, and up to $ 1 billion by the year 2000, in health expenditure. Under the U.S. Medicare system, patients requiring colorectal resections are assigned to diagnosis-related group 148 (DRG 148, colorectal resection with complications) or diagnosis-related group 149 (DRG 149, colorectal resection without complications) for hospital payments. The reimbursement is very different for these paired DRGs (149, $ 8310; 148, $ 20,291), and these payments are essentially fixed despite any increased expenditures by the hospital due to complications during the postoperative course. Therefore, the increased length of stay and hospital resource utilization that results from postoperative ileus leads to increased cost to the insurer and decreased margins to the hospital in a DRG system. Semin Colon Rectal Surg 16: 235-238 (C) 2005 Elsevier Inc. All rights reserved.
引用
收藏
页码:235 / 243
页数:9
相关论文
共 27 条
[1]   Implementation of a clinical pathway decreases length of stay and hospital charges for patients undergoing total colectomy and ileal pouch anal anastomosis [J].
Archer, SB ;
Burnett, RJ ;
Flesch, LV ;
Hobler, SC ;
Bower, RH ;
Nussbaum, MS ;
Fischer, JE .
SURGERY, 1997, 122 (04) :699-703
[2]   RETRACTED: Postoperative ileus: A review (Retracted Article - See vol 48, pg 1983, 2005) [J].
Baig, MK ;
Wexner, SD .
DISEASES OF THE COLON & RECTUM, 2004, 47 (04) :516-526
[3]  
Ballantyne G H, 1995, Gastroenterologist, V3, P75
[4]   A clinical pathway to accelerate recovery after colonic resection [J].
Basse, L ;
Jakobsen, DH ;
Billesbolle, P ;
Werner, M ;
Kehlet, H .
ANNALS OF SURGERY, 2000, 232 (01) :51-57
[5]   Laparoscopic-assisted vs open ileocolic resection for Crohn's disease - A comparative study [J].
Bemelman, WA ;
Slors, JFM ;
Dunker, MS ;
van Hogezand, RA ;
van Deventer, SJH ;
Ringers, J ;
Griffioen, G ;
Gouma, DJ .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2000, 14 (08) :721-725
[6]   Total parenteral nutrition in the critically ill patient [J].
Birmingham, CL .
LANCET, 1999, 353 (9159) :1116-1117
[7]   Standardized perioperative care protocols and reduced length of stay after colon surgery [J].
Bradshaw, BGG ;
Liu, SS ;
Thirlby, RC .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 1998, 186 (05) :501-506
[8]  
Cowan C, 2004, HEALTH CARE FINANC R, V25, P143
[9]   'Fast track' postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery [J].
Delaney, CP ;
Fazio, VW ;
Senagore, AJ ;
Robinson, B ;
Halverson, AL ;
Remzi, FH .
BRITISH JOURNAL OF SURGERY, 2001, 88 (11) :1533-1538
[10]   Factors affecting early postoperative feeding following elective open colon resection [J].
Di Fronzo, LA ;
Cymerman, J ;
O'Connell, TX .
ARCHIVES OF SURGERY, 1999, 134 (09) :941-945