Defects in Value Associated With Hospital-Acquired Conditions: How Improving Quality Could Save US Healthcare $50 Billion

被引:0
作者
Padula, William V. [1 ,2 ]
Pronovost, Peter J. [3 ,4 ]
机构
[1] Univ Southern Calif, Sch Pharm, Dept Pharmaceut & Hlth Econ, Los Angeles, CA USA
[2] Univ Southern Calif, Leonard D Schaeffer Ctr Hlth Policy & Econ, Los Angeles, CA USA
[3] Univ Hosp Cleveland Med Ctr, Cleveland, OH USA
[4] Case Western Reserve Univ, Sch Med, Cleveland, OH USA
基金
美国国家卫生研究院;
关键词
hospital-acquired condition; infection; pressure injury; value; cost; VENTILATOR-ASSOCIATED PNEUMONIA; ADVERSE EVENT RATES; LENGTH-OF-STAY; INFECTIONS; MORTALITY; TRENDS; IMPACT; COSTS;
D O I
10.1097/PTS.0000000000001259
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
U.S. hospital-acquired conditions cost almost $50 billion in nonreimbursable treatments annually, whereas an efficient healthcare delivery system that prioritizes prevention would only cost $15 billion. Hospital-acquired conditions in the United States are considered avoidable complications but remain common statistics reflecting on health system performance and are a leading cause of patient fatality. Currently, over 3.7 million patients experience a hospital-acquired condition in the United States each year, which costs the U.S. healthcare delivery system an excess of $48 billion. Evidence-based clinical practice guidelines for common hospital-acquired conditions (e.g., infections, falls, pressure injuries) to reduce risk to the patient. In each of these instances, preventing the outcome with these guidelines costs less than treating the outcome, in addition to keeping the patient safe from harm. By applying the framework of defects in value to hospital-acquired conditions, we estimate that U.S. health systems could avert this $48 billion in spending on treating harmful hospital-acquired conditions; more so, these systems of care could recuperate over $35 billion after investing proportionally in a system that delivers greater quality by preventing hospital-acquired conditions over treating them. Currently, the Centers for Medicare and Medicaid Services only withholds reimbursements for hospital-acquired conditions and penalizes health systems with high rates of these outcomes. However, payers do not offer any reward-based incentives for hospital-acquired condition prevention. A series of policy and health system solutions, including tracking of hospital-acquired condition rates in electronic health records, identifying centers of excellence at reducing rates of harm with the use of clinical practice guidelines, and rewarding them monetarily for reduced rates could create equal-sided risk and opportunity to engage health systems in improved performance.
引用
收藏
页码:512 / 515
页数:4
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