Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/174198 |
Resumo: | OBJECTIVES: Quality improvement (QI) initiatives based on data from international registries have been reported previously; however, there is a lack of information on the impact on the costs of medical care associated with the use of these tools. METHODS: Patients admitted due to myocardial infarction (MI), included in the ACTION Registrys and CathPCI Registrys, in a private Brazilian hospital (i.e., the reference hospital) were analyzed. The costs of care of these patients were compared to the costs of MI admissions in nine similar hospitals not included in the same QI program. Regression models were used to analyze the cost change over time between the two groups of hospitals. Readmission rates were compared using logistic regression, adjusting for the same variables as in the cost model. RESULTS: Overall, the annual medical cost inflation in Brazil was higher than the annual cost trend in the reference hospital during the period of analysis. Moreover, the annual in-hospital costs indicate that the reference hospital has a statistically significant 6% lower cost trend for patients with acute MI, compared to patients with the same diagnostic code in the comparison hospitals group, in an adjusted analysis (p-value=0.041). Using multivariable analysis, the readmission rates were also found to be significantly lower in the reference hospital than in the comparison hospitals, with an odds ratio of 0.68 (p-value=0.042). CONCLUSION: The use of the NCDRs as a benchmark to guide QI programs outside the United States was associated with the positive impact of bending the cost curve to below that of national medical inflation and the comparison hospitals’ costs, with a lower incidence of hospital readmission. |
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Clinics |
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Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality ImprovementCardiovascular DiseaseQuality ImprovementAppropriate Health CareOBJECTIVES: Quality improvement (QI) initiatives based on data from international registries have been reported previously; however, there is a lack of information on the impact on the costs of medical care associated with the use of these tools. METHODS: Patients admitted due to myocardial infarction (MI), included in the ACTION Registrys and CathPCI Registrys, in a private Brazilian hospital (i.e., the reference hospital) were analyzed. The costs of care of these patients were compared to the costs of MI admissions in nine similar hospitals not included in the same QI program. Regression models were used to analyze the cost change over time between the two groups of hospitals. Readmission rates were compared using logistic regression, adjusting for the same variables as in the cost model. RESULTS: Overall, the annual medical cost inflation in Brazil was higher than the annual cost trend in the reference hospital during the period of analysis. Moreover, the annual in-hospital costs indicate that the reference hospital has a statistically significant 6% lower cost trend for patients with acute MI, compared to patients with the same diagnostic code in the comparison hospitals group, in an adjusted analysis (p-value=0.041). Using multivariable analysis, the readmission rates were also found to be significantly lower in the reference hospital than in the comparison hospitals, with an odds ratio of 0.68 (p-value=0.042). CONCLUSION: The use of the NCDRs as a benchmark to guide QI programs outside the United States was associated with the positive impact of bending the cost curve to below that of national medical inflation and the comparison hospitals’ costs, with a lower incidence of hospital readmission.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2020-08-27info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/xmlhttps://www.revistas.usp.br/clinics/article/view/17419810.6061/clinics/2020/e1708Clinics; Vol. 75 (2020); e1708Clinics; v. 75 (2020); e1708Clinics; Vol. 75 (2020); e17081980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/174198/163043https://www.revistas.usp.br/clinics/article/view/174198/163044Copyright (c) 2020 Clinicsinfo:eu-repo/semantics/openAccessBarros, Pedro Gabriel Melo deLi, JohnTremblay, ChristineOkada, Mariana YumiSznejder, HenryFurlan, ValterVasconcellos, Rafael2020-08-27T21:34:05Zoai:revistas.usp.br:article/174198Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2020-08-27T21:34:05Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement |
title |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement |
spellingShingle |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement Barros, Pedro Gabriel Melo de Cardiovascular Disease Quality Improvement Appropriate Health Care |
title_short |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement |
title_full |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement |
title_fullStr |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement |
title_full_unstemmed |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement |
title_sort |
Cost Modifications during the Early Years of the Use of the National Cardiovascular Data Registry for Quality Improvement |
author |
Barros, Pedro Gabriel Melo de |
author_facet |
Barros, Pedro Gabriel Melo de Li, John Tremblay, Christine Okada, Mariana Yumi Sznejder, Henry Furlan, Valter Vasconcellos, Rafael |
author_role |
author |
author2 |
Li, John Tremblay, Christine Okada, Mariana Yumi Sznejder, Henry Furlan, Valter Vasconcellos, Rafael |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Barros, Pedro Gabriel Melo de Li, John Tremblay, Christine Okada, Mariana Yumi Sznejder, Henry Furlan, Valter Vasconcellos, Rafael |
dc.subject.por.fl_str_mv |
Cardiovascular Disease Quality Improvement Appropriate Health Care |
topic |
Cardiovascular Disease Quality Improvement Appropriate Health Care |
description |
OBJECTIVES: Quality improvement (QI) initiatives based on data from international registries have been reported previously; however, there is a lack of information on the impact on the costs of medical care associated with the use of these tools. METHODS: Patients admitted due to myocardial infarction (MI), included in the ACTION Registrys and CathPCI Registrys, in a private Brazilian hospital (i.e., the reference hospital) were analyzed. The costs of care of these patients were compared to the costs of MI admissions in nine similar hospitals not included in the same QI program. Regression models were used to analyze the cost change over time between the two groups of hospitals. Readmission rates were compared using logistic regression, adjusting for the same variables as in the cost model. RESULTS: Overall, the annual medical cost inflation in Brazil was higher than the annual cost trend in the reference hospital during the period of analysis. Moreover, the annual in-hospital costs indicate that the reference hospital has a statistically significant 6% lower cost trend for patients with acute MI, compared to patients with the same diagnostic code in the comparison hospitals group, in an adjusted analysis (p-value=0.041). Using multivariable analysis, the readmission rates were also found to be significantly lower in the reference hospital than in the comparison hospitals, with an odds ratio of 0.68 (p-value=0.042). CONCLUSION: The use of the NCDRs as a benchmark to guide QI programs outside the United States was associated with the positive impact of bending the cost curve to below that of national medical inflation and the comparison hospitals’ costs, with a lower incidence of hospital readmission. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-08-27 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/174198 10.6061/clinics/2020/e1708 |
url |
https://www.revistas.usp.br/clinics/article/view/174198 |
identifier_str_mv |
10.6061/clinics/2020/e1708 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/174198/163043 https://www.revistas.usp.br/clinics/article/view/174198/163044 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/xml |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 75 (2020); e1708 Clinics; v. 75 (2020); e1708 Clinics; Vol. 75 (2020); e1708 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222765209354240 |