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Robots, Weight Loss Surgery, and a Twisted Tale Out of Baltimore

Cheryl Clark, for HealthLeaders Media, February 21, 2013

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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1 comments on "Robots, Weight Loss Surgery, and a Twisted Tale Out of Baltimore"


WS (2/27/2013 at 12:31 PM)
Over-treatment and unnecessary treatment are making us sicker and poorer. The medical surgical industrial complex is too driven by the "almighty dollar." We need to return to conservative treatments and stop messing with "mother nature." This will likely require a complete overhaul of the "fee for service" payment structure. Take women's health, for example. The two most overused surgeries are c-section and hysterectomy. As part of the Choosing Wisely Campaign to reduce unnecessary tests and procedures, ACOG included c-section on their list. Why is hysterectomy not on this list? This is especially suspect since a study concluded that 76% of hysterectomies don't meet ACOG's criteria for the surgery. And healthy ovaries are removed in about 73% of hysterectomies so oophorectomy is another surgery that's WAY overused. Women's organs are being removed at alarming rates - 600,000+ hysterectomies every year with 1 in 2 women having one by age 72. Just as a man's SEX organs are needed for optimal health his entire life, so are a woman's.