Articles: cations.
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As the current healthcare structure moves toward value-based purchasing, it is helpful for stakeholders to understand costs, particularly for those associated with postoperative complications. The objectives of this study were to assess hospital reimbursements for postoperative complications and generate insight into sustainability of quality. ⋯ Postoperative complications add an important marginal cost to Medicare payments, and lead to a substantial portion of payments to hospitals. Using high-quality clinical registry data to measure complication rates, we estimated the cost of complications for 3 commonly performed operations among the Medicare population. Harmonizing financial incentives for both payers and providers are needed to improve the delivery of high-quality surgical care.
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The Fistula Risk Score (FRS) is a clinical tool developed from single-institutional data using primarily intraoperative factors to characterize the risk of clinically relevant pancreatic fistula (CR-POPF) after pancreaticoduodenectomy. We developed a modified FRS based on objective, nationally accrued data that is more readily determined before resection. ⋯ This modified FRS allows for estimation of CR-POPF risk using preoperative and easily determined intraoperative factors, and will allow comparison of performance data for individual surgeons to national norms, improved perioperative counseling, and potential for scrutinizing and/or implementing interventions designed to decrease CR-POPF rates.