Introduction: In this paper we investigate the possible connection between socioeconomic status as demarcated by employment and in-surance status and consumption of healthcare resources in spine surgery patients. Meth...Introduction: In this paper we investigate the possible connection between socioeconomic status as demarcated by employment and in-surance status and consumption of healthcare resources in spine surgery patients. Methods: The clinical records of 1599 spine surgery pa-tients counted from 2008-2009 were reviewed. The largest groups of patients belonged to MS-DRG 460 (N = 585) and to MS-DRG 473 (N = 700). These two MS-DRG patient groups were used as the study cohort representing patients who, by definition, did not have serious comor-bidities or complications. Results: Unemployed non-cervical patients tended to stay on average 1.8 days longer in hospital and had on average $5800 higher hospital charges. No major differ-ences were noted in length of stay and hospital cost between government and private insurance patients. However, self-pay non-cervical fusion patients had notable increases in length of stay and hospital cost, especially in the >39 and <60 age group with the difference in length of stay amounting to 5 days and in hospital charges to $10,000. Univariate analysis with DRG (460 or 473) as a covariate showed significant impact from employment status on length of stay (F = 4.259, P = 0.014) and less significant impact from payor category on hospital charges (F = 2.229, P = 0.064) in the economically-productive 40 -59 age group. Conclusions: In general, no increase in hospital resource consumption was noted except among self-pay patients, the same group seemingly least able to afford expensive healthcare.展开更多
This study reviewed a combination of health care programs in the metropolitan area of Syracuse, New York. They were designed to improve care, however a major purpose was to support efficiency. The study described a nu...This study reviewed a combination of health care programs in the metropolitan area of Syracuse, New York. They were designed to improve care, however a major purpose was to support efficiency. The study described a number of individual programs that were developed in order to improve the quality and the efficiency of care. These programs were implemented by a combination of local providers and payors. They included the development of outpatient services such as ambulatory surgery, as well as preventive care, case management, telemedicine, and mental health. The impact of these programs was a combination of these services, rather than individual efforts. The impact of these efforts was the product of a range of individual services, especially care management. Additional efforts should make it possible to extend these efforts among providers and payors in the Syracuse area. This approach should make it possible to extend the impact of health care efficiency further.展开更多
文摘Introduction: In this paper we investigate the possible connection between socioeconomic status as demarcated by employment and in-surance status and consumption of healthcare resources in spine surgery patients. Methods: The clinical records of 1599 spine surgery pa-tients counted from 2008-2009 were reviewed. The largest groups of patients belonged to MS-DRG 460 (N = 585) and to MS-DRG 473 (N = 700). These two MS-DRG patient groups were used as the study cohort representing patients who, by definition, did not have serious comor-bidities or complications. Results: Unemployed non-cervical patients tended to stay on average 1.8 days longer in hospital and had on average $5800 higher hospital charges. No major differ-ences were noted in length of stay and hospital cost between government and private insurance patients. However, self-pay non-cervical fusion patients had notable increases in length of stay and hospital cost, especially in the >39 and <60 age group with the difference in length of stay amounting to 5 days and in hospital charges to $10,000. Univariate analysis with DRG (460 or 473) as a covariate showed significant impact from employment status on length of stay (F = 4.259, P = 0.014) and less significant impact from payor category on hospital charges (F = 2.229, P = 0.064) in the economically-productive 40 -59 age group. Conclusions: In general, no increase in hospital resource consumption was noted except among self-pay patients, the same group seemingly least able to afford expensive healthcare.
文摘This study reviewed a combination of health care programs in the metropolitan area of Syracuse, New York. They were designed to improve care, however a major purpose was to support efficiency. The study described a number of individual programs that were developed in order to improve the quality and the efficiency of care. These programs were implemented by a combination of local providers and payors. They included the development of outpatient services such as ambulatory surgery, as well as preventive care, case management, telemedicine, and mental health. The impact of these programs was a combination of these services, rather than individual efforts. The impact of these efforts was the product of a range of individual services, especially care management. Additional efforts should make it possible to extend these efforts among providers and payors in the Syracuse area. This approach should make it possible to extend the impact of health care efficiency further.
