A study, published in JAMA Surgery, examined the link between early postoperative discharge after major surgery and overall surgical episode expenditures for postdischarge care for the Medicare population.
The cross-sectional cohort study of Medicare beneficiaries included patients undergoing colectomy (189,229 patients), coronary artery bypass grafting (218,940 patients) or total hip replacement (231,774 patients). The study period extended from Jan. 1, 2009, to June 30, 2012.
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Here are four insights:
1. Total surgical episode spending among patients with high risk of postoperative complication were lower at hospitals with shorter lengths of stay. For example, total cost of total hip replacements at short LOS hospitals was $26,482 for high-risk patients as compared to $29,250 at long LOS hospitals.
2. Shortest LOS hospitals did not show an increase in payments for postdischarge care use:
• Colectomy: $4,011 for low LOS hospitals versus $5,083 at high LOS hospitals
• Coronary artery bypass grafting: $6,015 versus $6,355
• Total hip replacement: $7,132 versus $9,552
3. Additionally, short LOS hospitals did not show an increase in payments for readmissions.
4. The study authors note that there is no evidence showing that cost savings from shorter LOS are offset by higher postdischarge care spending.