January 23, 2019

Effect of referring high-risk patients to local high-quality hospitals

By: Judy Mathias

Editor’s Note

In this study, complication rates and Medicare payments were significantly lower for high-risk surgical patients treated at local high-quality hospitals.

Analyzing elderly Medicare patients having any of four elective inpatient surgical procedures between 2012 and 2014, researchers found that one-fourth of high-risk patients had surgery at a low-quality hospital despite the availability of a high-quality hospital in their geographic area.

Shifting these patients to a local high-quality hospital would decrease spending 12% to 37%:

  • $2,500 for total knee and hip replacement
  • $6,700 for colectomy
  • $11,400 for lung resection.

The findings suggest that triaging high-risk surgical patients to local high-quality hospitals could be a template for improving the value of care, the researchers say.


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