Referring surgical patients to better hospitals saves lives

A Health Affairs study this month found that patient safety efforts to eliminate surgical complications could hurt hospital revenue. Researchers pointed out that for hospitals where surgical inpatient volume is not growing, programs to reduce surgical complications create negative cash flow, FierceHealthcare reported this week.

A separate study in Wednesday's Forum for Health Economics and Policy might offer some good news for hospitals that are looking to balance surgical patient care with costs. According to Houston's Rice University researchers, referring cancer patients to hospitals with better surgical track records could save lives and at no additional costs to patients.

Using data from the American Hospital Association, Medicare and market research, researchers looked at two types of surgery--pancreatic resection, which is a complicated procedure and has a higher mortality rate over colon resection.

Despite concerns that referring patients to a few hospitals would create market dominance and price fixing, the researchers found when low-volume hospitals redirected surgical patients to high-volume hospitals, mortality rates dropped for pancreatic cancer patients, although not for colon cancer.
They found that "centralizing pancreatic cancer surgery is unambiguously welfare enhancing," according to the study, but less so for colon cancer surgery. Researchers noted the market concentration led to higher costs and prices for colon cancer, but not pancreatic cancer patients.

"If all patients needing surgery for colon cancer were referred to hospitals that have consistently achieved mortality rates in the bottom half of all hospitals performing this operation, then the average mortality rate could fall from a rate of 3.8 percent to 2.4 percent," Vivian Ho, a professor of economics at Rice University, said in the statement. "And if all patients who require surgical resection for pancreatic cancer were referred to hospitals performing 11 or more of these operations per year, mortality rates could fall by half, from a rate of 6 percent to 3 percent."

For more information:
- see the Rice University announcement
- check out the study abstract

Related Articles:
Hospital revenue takes a hit with surgical safety efforts
Study: Certificate of need won't curb healthcare costs
Surgeons unhappy with OR resources, work-life balance
Surgery mortality rates underestimated