Surgery at High-Quality Hospitals a Money-Saver for Medicare
Having major surgery at a high-quality hospital costs Medicare less than the same procedure at a low-quality hospital, a new study finds.
The savings come mostly from the cost of post-surgical care, the researchers said.
"In much of health care, better care costs more money but surgery may be one situation in which getting care at a high-quality hospital not only saves lives, but also saves money. And that is a win for everyone," said study senior author Dr. Ashish Jha. Jha is a professor of international health at the Harvard T.H. Chan School of Public Health in Boston, and director of the Harvard Global Health Institute.
The researchers reviewed 2011-2012 Medicare data on five types of major surgery. The surgeries included heart bypass surgery, removal of part of a lung, repair of abdominal aortic aneurysm, surgical removal of all or part of the colon, and hip replacement.
The researchers looked at the costs of the procedures and care for more than 110,000 Medicare beneficiaries 30 days after surgery, and for nearly 94,000 patients 90 days after surgery.
The quality level of a hospital was based on 30-day surgical death rates and patient satisfaction with their care, the researchers said.
On average, Medicare spent about $32,000 per patient, the study found. That figure included initial hospitalization and the first 30 days of follow-up care.
However, costs varied substantially between surgeries and hospitals.
For patients at high-quality hospitals, Medicare spent about $2,700 less over 30 days than for patients at low-quality hospitals.
High-quality hospitals saved Medicare about $2,200 at 90 days post-surgery compared to low-quality hospitals, the researchers said.
Nearly two-thirds of the savings were due to lower use of post-surgery care services at high-quality hospitals compared to low-quality hospitals. These services included stays in a rehabilitation facility or care from home health aides.
"Of course, it is worth remembering that the goal of health care is not to save money, but to save lives," Jha said in a university news release.
"These high-quality hospitals, which had lower spending, had mortality rates that were less than half of what we saw at the low-quality hospitals. The findings should provide real impetus for policymakers to help patients choose high-quality hospitals," he added.
The study was published online Sept. 7 in the journal Health Affairs.
The U.S. National Library of Medicine outlines how to choose the best hospital for surgery.