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VALUE ASSESSMENT FOR HERNIA REPAIRS PROGRAM AT AN ACADEMIC HEALTH NETWORK SYSTEM OVER 12 YEARS
Michael Abdelmasseh
*, Araceli D. Cuaranta, Errington C. Thompson, Robert Finley, Carol Faris, Barbara Payne, Alexei Gorka, Jonathan Willis, Vineela Kadiyala, Juan Sanabria
Marshall University Joan C Edwards School of Medicine, Huntington, WV
BACKGROUND. Hernia repairs (HR) are among the most common surgeries in the US, costing around $2.5 billion annually. Healthcare stakeholders and policymakers are introducing new policies to improve service quality and reduce costs. We aim to assess the value of HR services in our healthcare network and identify the affecting factors.
METHODS. HR patients' data was collected from a Health System warehouse retrospectively (Jan-2010 – July-2016) and prospectively (Aug-2016 – Dec-2021) under IRB-approved protocols. Value was assessed based on quality and cost domains. Quality was determined as observed-O and compared to expected-E surrogates as postoperative complication rates-PCs, length of stay-LOS, and 30-day readmission rates-RA, while cost was determined using surrogates including total hospital charges-TC, and reimbursement index. SPSS was used for uni/multivariate analyses to identify value-affecting factors.
RESULTS. Among 4998 HR patients (inguinal HR, (n=2643), epigastric/umbilical HR (n=1523), or incisional HR (n=832)), half of them (58%) had open surgeries. Incisional HR showed higher PCs and RA than epigastric/umbilical HR and inguinal HR (PCs: 25%, 7.5%, 4.9% & RA: 6.7%, 2.8%,0.7%, respectively). Multivariate analyses showed procedure types (open vs. MI) and mesh usage were common factors affecting PCs and LOS in all three groups. Value indicators exceeded national averages for all three groups except for LOS and TC.
CONCLUSION. Hernia repair services showed a high value in our healthcare system when compared to the national average.
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