Preparing For Bundled Payment Scheme

Impact Of Complications On Institutional Cost

Bundled payments for coronary artery bypass grafting (CABG) provide a single reimbursement for care provided from admission through 90 days post-discharge. We aim to explore the impact of complications on total institutional costs, as well as the drivers of high costs for index hospitalization.

The study was undertaken by the Vanderbilt University Medical Center, Nashville, Tennessee, D. Haddad et Al.

clinical and internal cost data for patients undergoing CABG from 2014 to 2017 were linked. The factors for variable direct costs, excess cost. value-based outcomes (readmissions) and post acute care utilisation.

The study reviewed a total of 1789 patients undergoing CABG. A significant proportion of patients were diabetic and obese (51,7%).

Preoperative characteristics had less of an impact on costs post-CABG than postoperative complications.

Postoperative complications vary in their impact on internal costs, the main factors for cost were re-operation, stroke, and renal failure.

In conclusion: In preparation for bundled payments, hospitals should focus on understanding and preventing drivers of high cost.

Link to the study: https://pubmed.ncbi.nlm.nih.gov/32896546/

How to prevent post-op complications and re-operations visit the "Solution" section of this website.