Robots, Weight Loss Surgery, and a Twisted Tale Out of Baltimore
The finding of the bariatric surgery study might give pause to any organization that thinks integrated delivery systems (IDS) or accountable care organizations will reduce costs in the big ticket arena of expensive hospital care as it has been shown to do in less intense ambulatory care settings.
Also in this week's issue of JAMA Surgery, research physicians and colleagues from the Center for Healthcare Outcomes and Policy at the University of Michigan found that among four procedures studied, there was little difference in key quality measures such as operative mortality, post operative complications, readmissions and total surgical episode costs between hospitals with IDS and those without.
"For each of the four procedures, (coronary bypass grafts, hip replacement, back surgery, and colectomy) adjusted rates for operative mortality, complications and readmissions were similar for patients treated in IDS-affiliated compared with non-IDS affiliated hospitals, with the exception that those treated in IDS affiliated hospital shad fewer readmissions after colectomy," the researchers wrote.
With the exception of hip replacement surgery, for which total episode of care cost 4% less at IDS hospitals because of reductions in post-discharge costs, "episode payments differed by 1% or less for the remaining procedures."
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