There is wide variation in post-surgery care costs between hospitals in the top post-surgery spending quintile and and lowest spending quintile, according to research published Monday by Health Affairs.
Average post-surgery care costs were 129% higher for hip replacements in the highest spending quintile than the lowest spending quintile, 103% higher for coronary artery bypass grafting (CAPG), and 82% for colectomy.
- After adjusting for post-surgery care setting, average variations dropped to 16% for hip replacements, 4% for CAPG, and 21% for colectomy.
Where hospitals refer patients following surgery can indicate how much care for those patients will cost. Hospitals in the study with the highest spending on average were more likely to refer a larger share of patients to inpatient rehabilitation facilities or skilled nursing facilities while those with the lowest spending were more likely to prescribe home health care or outpatient rehabilitation.
There is little in the way of formal guidelines for physicians to follow when referring patients for post-acute care, as lead author Dr. Lena Chen noted in a statement. “Once providers better understand what setting has value and when, the payment system can better incentivize appropriate decisions.”
As more details on variations in healthcare spending become available, more of these guidelines could emerge. Another study published recently showed similarly large variations in adverse outcome rates for joint replacement patients depending on where they were treated.