Did Postoperative Mortality Increase After the Implementation of the Medicare Balanced Budget Act
Bibliographic Data
| ID | 9103728 |
|---|---|
| Authors | Meena Seshamani (Johns Hopkins University), Jingsan Zhu (University of Pennsylvania), Kevin G Volpp (0000-0003-3389-6707, Veterans Health Administration, corresponding author) |
| Year | 2006 |
| Volume | 44 |
| Issue | 6 |
| Pages | 527-533 |
| Publication date | 2006-06-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/01.mlr.0000215886.49343.c6 |
| PMID | 16708001 |
| OpenAlex | W2068324330 |
| Language | EN |
| Citations received | 3 |
| References cited | 30 |
BACKGROUND: The Balanced Budget Act (BBA) of 1997 was a cost-saving measure designed to reduce Medicare reimbursements by $116.4 billion from 1998 to 2002. Resulting financial strain could adversely affect the quality of patient care in hospitals. OBJECTIVE: We sought to determine whether 30-day mortality rates for surgical patients who developed complications changed at different rates in hospitals under different levels of financial strain from the BBA. METHODS: Pennsylvania hospital discharge data, financial data, and death certificate data from 1997 to 2001 were obtained. A retrospective multivariate analysis examined whether 30-day mortality rates from 8 postoperative complications varied based on degree of hospital financial strain. RESULTS: The average magnitude of Medicare payment reduction on overall hospital net revenues was estimated at 1.8% for hospitals with low BBA impact and 3.5% for hospitals with high impact in 1998, worsening to 2.0% and 4.8%, respectively, by 2001. Mortality rates changed at similar rates for high- and low-impact hospitals from 1997 to 1999, but from 1997 to 2000 mortality rates increased more among patients in high-impact compared with low-impact hospitals (P<0.05). From 2000 to 2001, mortality rates among impact groups converged. There were no statistically significant differences based on BBA impact in changes in nursing staff or length of stay. CONCLUSIONS: The mortality of surgical patients who developed postoperative complications increased to a greater degree in the short term in hospitals affected more by BBA. Measuring the quality impact of reimbursement cuts is necessary to understand cost-quality tradeoffs that may accompany cost-saving reforms
Health care · Mortality rate · Reimbursement · Retrospective cohort study · Economic and Financial Impacts of Cancer · Emergency Medicine · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Internal Medicine · Medicine
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Nurse-Staffing Levels and the Quality of Care in Hospitals
A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity
The Relationship of Hospital Characteristics and the Results of Peer Review in Six Large States
The Balanced Budget Act of 1997 and U.S. Hospital Operations
Comorbidity Measures for Use with Administrative Data
Predicting In-Hospital Mortality
Hospital and Patient Characteristics Associated With Death After Surgery
Postoperative Adverse Events of Common Surgical Procedures in the Medicare Population
A Spurious Correlation Between Hospital Mortality and Complication Rates
| Unique citing works | 3 |
|---|---|
| Citations per year | 0,17 |
| Citation span | 2008 - 2016 (9) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 2 |