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Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements

The aging population and the associated demand for orthopedic surgeries are increasing health costs. Although the Diagnostic Related Groups (DRG) system was introduced to offer incentives for hospitals, concerns remain that reimbursements for older and frail patients do not cover all hospital expens...

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Autores principales: Rohrer, Felix, Farokhnia, Aresh, Nötzli, Hubert, Haubitz, Frederik, Hermann, Tanja, Gahl, Brigitta, Limacher, Andreas, Brügger, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998626/
https://www.ncbi.nlm.nih.gov/pubmed/35410007
http://dx.doi.org/10.3390/ijerph19074325
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author Rohrer, Felix
Farokhnia, Aresh
Nötzli, Hubert
Haubitz, Frederik
Hermann, Tanja
Gahl, Brigitta
Limacher, Andreas
Brügger, Jan
author_facet Rohrer, Felix
Farokhnia, Aresh
Nötzli, Hubert
Haubitz, Frederik
Hermann, Tanja
Gahl, Brigitta
Limacher, Andreas
Brügger, Jan
author_sort Rohrer, Felix
collection PubMed
description The aging population and the associated demand for orthopedic surgeries are increasing health costs. Although the Diagnostic Related Groups (DRG) system was introduced to offer incentives for hospitals, concerns remain that reimbursements for older and frail patients do not cover all hospital expenses. We investigated further: (1) Does age influence net financial results in orthopedic surgery? (2) Are there patient or surgical factors that influence results? This retrospective, monocentric study compares costs and reimbursements for orthopedic patients in a tertiary care hospital in Switzerland between 2015 and 2017. The data of 1230 patients were analyzed. Overall, the net results for the hospital were positive, despite 19.5% of patients being treated at a loss. We did not find any correlation between age and profitability (p = 0.61). Patient-related factors associated with financial losses were female sex (p < 0.001) and diabetes (p = 0.013). Patients free of serious comorbidities (p = 0.012) or with a higher cost weight (p < 0.001) were more often profitable. A longer length of stay was associated with higher losses (p < 0.001). This is the first study to address the Swiss DRG reimbursement system in a broad orthopedic population, while also analyzing specific patient and surgical factors. Overall, the reimbursement system is fair, but could better account for certain interventions.
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spelling pubmed-89986262022-04-12 Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements Rohrer, Felix Farokhnia, Aresh Nötzli, Hubert Haubitz, Frederik Hermann, Tanja Gahl, Brigitta Limacher, Andreas Brügger, Jan Int J Environ Res Public Health Article The aging population and the associated demand for orthopedic surgeries are increasing health costs. Although the Diagnostic Related Groups (DRG) system was introduced to offer incentives for hospitals, concerns remain that reimbursements for older and frail patients do not cover all hospital expenses. We investigated further: (1) Does age influence net financial results in orthopedic surgery? (2) Are there patient or surgical factors that influence results? This retrospective, monocentric study compares costs and reimbursements for orthopedic patients in a tertiary care hospital in Switzerland between 2015 and 2017. The data of 1230 patients were analyzed. Overall, the net results for the hospital were positive, despite 19.5% of patients being treated at a loss. We did not find any correlation between age and profitability (p = 0.61). Patient-related factors associated with financial losses were female sex (p < 0.001) and diabetes (p = 0.013). Patients free of serious comorbidities (p = 0.012) or with a higher cost weight (p < 0.001) were more often profitable. A longer length of stay was associated with higher losses (p < 0.001). This is the first study to address the Swiss DRG reimbursement system in a broad orthopedic population, while also analyzing specific patient and surgical factors. Overall, the reimbursement system is fair, but could better account for certain interventions. MDPI 2022-04-04 /pmc/articles/PMC8998626/ /pubmed/35410007 http://dx.doi.org/10.3390/ijerph19074325 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rohrer, Felix
Farokhnia, Aresh
Nötzli, Hubert
Haubitz, Frederik
Hermann, Tanja
Gahl, Brigitta
Limacher, Andreas
Brügger, Jan
Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements
title Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements
title_full Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements
title_fullStr Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements
title_full_unstemmed Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements
title_short Profit-Influencing Factors in Orthopedic Surgery: An Analysis of Costs and Reimbursements
title_sort profit-influencing factors in orthopedic surgery: an analysis of costs and reimbursements
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8998626/
https://www.ncbi.nlm.nih.gov/pubmed/35410007
http://dx.doi.org/10.3390/ijerph19074325
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