Culler Steven D, Jevsevar David S, Shea Kevin G, Wright Kimberly K, Simon April W
Rollins School of Public Health, Emory University, Atlanta, Georgia.
Medical Director of Orthopedic Clinical Program, Intermountain Healthcare, St. George, Utah.
J Arthroplasty. 2015 Jan;30(1):19-25. doi: 10.1016/j.arth.2014.08.023. Epub 2014 Sep 6.
This paper estimates the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries undergoing TKA. This retrospective study, using the Medicare Provider Analysis and Review file, identified 353,650 Medicare beneficiaries who underwent a primary TKA during 2011. Overall, 11.82% of Medicare beneficiaries (MBs) undergoing TKA experienced at least one of the study's adverse events. MBs experiencing any adverse event consumed significantly more unadjusted hospital resources ($3110 cost) and had longer stays (1.3 days). The risk-adjusting incremental cost of treating adverse events ranged between $30,902 (pneumonia) and $2167 (hemorrhage or post-operative shock requiring transfusion). Most major adverse events occur infrequently; however when an adverse event occurs following TKA, it adds substantially to hospital costs.
本文估算了与治疗接受全膝关节置换术(TKA)的医疗保险受益人的特定不良事件相关的医院资源消耗增量。这项回顾性研究利用医疗保险提供者分析与审查文件,确定了2011年期间接受初次全膝关节置换术的353,650名医疗保险受益人。总体而言,接受全膝关节置换术的医疗保险受益人中有11.82%经历了至少一项该研究中的不良事件。经历任何不良事件的医疗保险受益人消耗的未调整医院资源显著更多(成本为3110美元),住院时间也更长(1.3天)。治疗不良事件的风险调整增量成本在30,902美元(肺炎)至2167美元(出血或需要输血的术后休克)之间。大多数主要不良事件很少发生;然而,当全膝关节置换术后发生不良事件时,会大幅增加医院成本。