Surgical procedures in inpatient versus outpatient settings and its potential impact on follow-up costs
Bibliographic Data
| ID | 21468069 |
|---|---|
| Authors | Beat Brüngger (0000-0001-6173-5375, Helsana Group (Switzerland)), Caroline Bähler (0000-0002-4650-1463, University of Zurich, corresponding author), Matthias Schwenkglenks (0000-0001-7217-1173, University of Zurich), Agnė Ulytė (0000-0001-7419-9778, University of Zurich), Holger Dressel (0000-0002-1268-0416, Prevention Institute), Viktor Von Wyl (0000-0002-8754-9797, University of Zurich), Oliver Gruebner (0000-0001-9783-4770, University of Zurich), Wenjia Wei (0000-0002-1977-8416, University of Zurich), Miquel Serra‐Burriel (0000-0001-8595-1224, University of Zurich), Miquel Serra-Burriel, Eva Blozik (University of Zurich) |
| Year | 2021 |
| Volume | 125 |
| Issue | 10 |
| Pages | 1351-1358 |
| Publication date | 2021-10-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy (JOURNAL) |
| Journal identifiers | ISSN: 0168-8510 • E-ISSN: 1872-6054 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.healthpol.2021.07.006 |
| PMID | 34348846 |
| OpenAlex | W3185682884 |
| Language | EN |
| Citations received | 2 |
| References cited | 14 |
OBJECTIVE: We examined real-world effects of cantonal legislations to direct surgery patients from the inpatient to the outpatient setting in Switzerland. METHODS: Analyses were based on claims data of the Helsana Group, a leading Swiss health insurance. The study population consisted of 13'145 (in 2014), 12'455 (in 2016), and 12'875 (in 2018) insured persons aged >18 years who had haemorrhoidectomy, inguinal hernia repair, varicose vein surgery, knee arthroscopy/meniscectomy or surgery of the cervix/uterus. We assessed the proportion of inpatient procedures, index costs, length of hospital stays, outpatient costs and hospitalizations during follow-up, stratified by procedure, in-/outpatient setting, and the presence (enacted/effective in 2018) of a cantonal legislation. We used difference-in-differences methods to study the impact of cantonal legislations. RESULTS: Overall, the proportion of procedures performed in the inpatient setting decreased between 2014 and 2018 (p < 0.001). The decrease between 2016 and 2018 was significantly steeper in cantons with a legislation (p < 0.001; effect size: 0.57; 95% CI: 0.51, 0.64), leading to steeper decreases in healthcare costs of index procedures in cantons with a legislation, with no impact on length of hospital stays. The legislation also had no impact on outpatient costs or hospitalizations during follow-up. CONCLUSIONS: The cantonal legislations achieved the intended effects of inpatient surgery substitution by outpatient surgery, with no evidence suggesting negative effects on costs or hospitalizations during follow-up
Ambulatory · Ambulatory care · Environmental health · Health care · Inpatient care · Legislation · Outpatient surgery · Population · Varicose veins · Cardiac, Anesthesia and Surgical Outcomes · Enhanced Recovery After Surgery · Healthcare Operations and Scheduling Optimization · Medicine · Emergency Medicine · Surgery
| Unique citing works | 2 |
|---|---|
| Citations per year | 1 |
| Citation span | 2024 - 2024 (1) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 2 |