National Healthcare Quality and Disparities Report
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedScott JW, Neiman PU, Scott KW
High deductibles are associated with severe disease, catastrophic out-of-pocket payments for emergency surgical conditions.
This retrospective analysis of claims data examined the association of a high-deductible health insurance plan (HDHP) with severe disease and catastrophic out-of-pocket payments for emergency surgical conditions (e.g., appendicitis, cholecystitis, diverticulitis, and intestinal obstruction). Primary outcome was disease severity at presentation-determined using ICD-10-CM diagnoses codes and based on validated measures of anatomic severity (e.g., perforation, abscess, diffuse peritonitis). The secondary outcome was catastrophic out-of-pocket spending, defined by the World Health Organization as out-of-pocket spending >10% of annual income. Among 43,516 patients [mean age 48.4 years; 51% female], 41% were enrolled in HDHPs. Despite being younger, healthier, wealthier, and more educated, HDHP enrollees were more likely to present with more severe disease (28.5% vs 21.3%); even after adjusting for relevant demographics. HDHP enrollees were also more likely to incur 30-day out-of-pocket spending that exceeded 10% of annual income (20.8% vs 6.4%).
AHRQ-funded; HS027788; HS028672.
Citation: Scott JW, Neiman PU, Scott KW .
High deductibles are associated with severe disease, catastrophic out-of-pocket payments for emergency surgical conditions.
Ann Surg 2023 Oct 1; 278(4):e667-e74. doi: 10.1097/sla.0000000000005819..
Keywords: Health Insurance, Healthcare Costs, Payment, Surgery
Ko H, Martin BI, Nelson RE
How does the effect of the comprehensive Care for Joint Replacement model vary based on surgical volume and costs of care?
This article described differences in costs, quality, and patient selection between hospitals that continued to participate in the comprehensive Care for Joint Replacement (CJR) program after the CMS policy revision and those that withdrew from CJR before and after the implementation of CJR. Study subjects were Medicare beneficiaries who had undergone elective lower extremity joint replacement from 2013 to 2017. The results indicated that hospitals that continued to participate in CJR achieved a greater cost reduction. The authors noted that these the cost reductions were partly attributable to the avoidance of potential higher-cost patients.
AHRQ-funded; HS024714.
Citation: Ko H, Martin BI, Nelson RE .
How does the effect of the comprehensive Care for Joint Replacement model vary based on surgical volume and costs of care?
Med Care 2023 Jan;61(1):20-26. doi: 10.1097/mlr.0000000000001785..
Keywords: Orthopedics, Surgery, Healthcare Costs, Medicare, Payment