Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients

Henry A. Pitt, Ella Tsypenyuk, Susan L. Freeman, Steven R. Carson, Jonathan A. Shinefeld, Sally M. Hinkle, Benjamin D. Powers, Amy J. Goldberg, Verdi J. Disesa, Larry R. Kaiser

Research output: Contribution to journalArticle

Abstract

Background Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Study Design Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. Results For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Conclusions Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients.

Original languageEnglish (US)
Pages (from-to)568-575
Number of pages8
JournalJournal of the American College of Surgeons
Volume222
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Fingerprint

Costs and Cost Analysis
Quality Improvement
Mortality
Safety-net Providers
Cost Control
Hospital Costs
Social Responsibility
Patient Safety
Patient Satisfaction
Practice Guidelines
Cost-Benefit Analysis
Length of Stay

ASJC Scopus subject areas

  • Surgery

Cite this

Pitt, H. A., Tsypenyuk, E., Freeman, S. L., Carson, S. R., Shinefeld, J. A., Hinkle, S. M., ... Kaiser, L. R. (2016). Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients. Journal of the American College of Surgeons, 222(4), 568-575. https://doi.org/10.1016/j.jamcollsurg.2015.12.046

Transforming Patient Value : Comparison of Hospital, Surgical, and General Surgery Patients. / Pitt, Henry A.; Tsypenyuk, Ella; Freeman, Susan L.; Carson, Steven R.; Shinefeld, Jonathan A.; Hinkle, Sally M.; Powers, Benjamin D.; Goldberg, Amy J.; Disesa, Verdi J.; Kaiser, Larry R.

In: Journal of the American College of Surgeons, Vol. 222, No. 4, 01.04.2016, p. 568-575.

Research output: Contribution to journalArticle

Pitt, HA, Tsypenyuk, E, Freeman, SL, Carson, SR, Shinefeld, JA, Hinkle, SM, Powers, BD, Goldberg, AJ, Disesa, VJ & Kaiser, LR 2016, 'Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients', Journal of the American College of Surgeons, vol. 222, no. 4, pp. 568-575. https://doi.org/10.1016/j.jamcollsurg.2015.12.046
Pitt, Henry A. ; Tsypenyuk, Ella ; Freeman, Susan L. ; Carson, Steven R. ; Shinefeld, Jonathan A. ; Hinkle, Sally M. ; Powers, Benjamin D. ; Goldberg, Amy J. ; Disesa, Verdi J. ; Kaiser, Larry R. / Transforming Patient Value : Comparison of Hospital, Surgical, and General Surgery Patients. In: Journal of the American College of Surgeons. 2016 ; Vol. 222, No. 4. pp. 568-575.
@article{8148104c20fc433daccdb0b4f73553be,
title = "Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients",
abstract = "Background Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Study Design Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. Results For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Conclusions Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients.",
author = "Pitt, {Henry A.} and Ella Tsypenyuk and Freeman, {Susan L.} and Carson, {Steven R.} and Shinefeld, {Jonathan A.} and Hinkle, {Sally M.} and Powers, {Benjamin D.} and Goldberg, {Amy J.} and Disesa, {Verdi J.} and Kaiser, {Larry R.}",
year = "2016",
month = "4",
day = "1",
doi = "10.1016/j.jamcollsurg.2015.12.046",
language = "English (US)",
volume = "222",
pages = "568--575",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Transforming Patient Value

T2 - Comparison of Hospital, Surgical, and General Surgery Patients

AU - Pitt, Henry A.

AU - Tsypenyuk, Ella

AU - Freeman, Susan L.

AU - Carson, Steven R.

AU - Shinefeld, Jonathan A.

AU - Hinkle, Sally M.

AU - Powers, Benjamin D.

AU - Goldberg, Amy J.

AU - Disesa, Verdi J.

AU - Kaiser, Larry R.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Study Design Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. Results For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Conclusions Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients.

AB - Background Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Study Design Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. Results For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Conclusions Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients.

UR - http://www.scopus.com/inward/record.url?scp=84962339077&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84962339077&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2015.12.046

DO - 10.1016/j.jamcollsurg.2015.12.046

M3 - Article

C2 - 26916131

AN - SCOPUS:84962339077

VL - 222

SP - 568

EP - 575

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 4

ER -