PMID: 6412640Sep 1, 1983Paper

Toward strategies for cost containment in surgical patients

Annals of Surgery
W R DruckerG Ingersoll

Abstract

The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital costs. In 1980, 3935 patients at Strong Memorial Hospital (SMH) had at least one contact with a general surgical patient care or intensive care unit; 261 patients (6.6%) had total 1980 charges of more than $20,000 each. They contributed 32% of the total of both general surgical charges and patient days. A subset of 2021 patients was selected to represent more precisely the general surgical patient. The 85 high-cost patients (4.2%) of this subset were chosen for intensive study. These patients generated a significant and disproportionate per cent of total (2021) general surgical charges (26.8%) and hospital days (27.6%). Average total charges were more than 8 times those of the complementary general surgical subset (1936). Nineteen of the 85 patients (22.3%) died in the hospital and 42 patients (49.4%) were dead within 2 1/2 years. Forty patients (of the 85) were then further identified as "complex", based on multiple,...Continue Reading

References

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Citations

May 1, 1987·Journal of General Internal Medicine·P F Griner, L P Brideau
Nov 1, 1986·Canadian Anaesthetists' Society Journal·M J Girotti, S J Brown
Apr 1, 1994·Annals of Surgery·S H PedersenT J Eberlein
Oct 1, 1985·Annals of Surgery·J M Civetta, J A Hudson-Civetta
Sep 1, 1991·World Journal of Surgery·J A Heine, D A Rothenberger
Sep 1, 1987·The Australian and New Zealand Journal of Surgery·J E PayneP H Chapuis
Feb 1, 1996·The Surgical Clinics of North America·O C KirtonJ Hudson-Civetta
Sep 1, 1988·JPEN. Journal of Parenteral and Enteral Nutrition·L FlancbaumJ W Mackenzie

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