National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 2 of 2 Research Studies DisplayedMafi JN, Godoy-Travieso P, Wei E
Evaluation of an intervention to reduce low-value preoperative care for patients undergoing cataract surgery at a safety-net health system.
This study analyzed the effects of an intervention program to reduce preoperative costs for care in patients undergoing cataract surgery. Most surgery centers require a battery of tests before surgery is approved. All patients must undergo primary care visits with chest x-rays, laboratory tests, and electrocardiograms required for many of them depending on age and presence of other conditions. This case-control study was conducted at 2 academic safety-net medical centers, Los Angeles County and University of Southern California (LAC-USC) (intervention, n = 469) and Harbor-UCLA (University of California, Los Angeles) (control, n = 585), from April 13, 2015, through April 12, 2016, with 12 additional months (April 13, 2016, through April 13, 2017) to assess sustainability (intervention, n = 1002; control, n = 511). All preoperative care decreased in the intervention group and mostly decreased in the control group. Financial losses occurred at these centers, but there was an overall savings for patients and society. These findings suggest that this may be a barrier to eliminating low-value care.
AHRQ-funded; HS024067.
Citation: Mafi JN, Godoy-Travieso P, Wei E .
Evaluation of an intervention to reduce low-value preoperative care for patients undergoing cataract surgery at a safety-net health system.
JAMA Intern Med 2019 May;179(5):648-57. doi: 10.1001/jamainternmed.2018.8358..
Keywords: Healthcare Costs, Surgery, Eye Disease and Health, Quality Improvement, Quality of Care
Nathan H, Thumma JR, Ryan AM
Early impact of Medicare accountable care organizations on inpatient surgical spending.
This study evaluated whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. Medicare Shared Savings Programs (MSSP) have shown some modest success in reducing overall medical spending, but has not been studied on its impact in reducing surgical spending. Medicare claims from 2010 to 2014 were evaluated for patients aged 65 to 99 years undergoing 6 common elective surgical procedures: abdominal aortic aneurysm, colectomy, coronary artery bypass grafting, hip or knee replacement, or lung resection. A total of 341,675 patients at 427 ACO hospitals and over 1 million matched controls at non-ACO hospitals were used to compare surgical costs. There was not an overall reducing in total Medicare patients between the two hospital types.
AHRQ-funded; HS024763.
Citation: Nathan H, Thumma JR, Ryan AM .
Early impact of Medicare accountable care organizations on inpatient surgical spending.
Ann Surg 2019 Feb;269(2):191-96. doi: 10.1097/sla.0000000000002819..
Keywords: Healthcare Costs, Hospitals, Inpatient Care, Medicare, Surgery, Quality of Care