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Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients
Journal article   Peer reviewed

Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients

Henry A Pitt, Ella Tsypenyuk, Susan L Freeman, Steven R Carson, Jonathan A Shinefeld, Sally M Hinkle, Benjamin D Powers, Amy J Goldberg, Verdi J DiSesa and Larry R Kaiser
Journal of the American College of Surgeons, v 222(4), pp 568-575
01 Apr 2016
DOI: https://doi.org/10.1016/j.jamcollsurg.2015.12.046
PMID: 26916131
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Academic Medical Centers Adult Aged Direct Service Costs Female General Surgery Hospital Mortality Humans Length of Stay Male Middle Aged Patient Safety Patient Satisfaction Quality Improvement Risk Adjustment Safety-net Providers Treatment Outcome
Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients.

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8 citations in Web of Science
8 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Web of Science research areas
Surgery
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