Home > Research . Search . Country . Browse . Small Grants

PSC In The News

RSS Feed icon

Detroit Mayor challenges U-M to analyze root causes, patterns of murders in city

Lam on what helps and hurts in world-wide youth unemployment

Buchmueller says must-access program curbs doctor-shopping for opioids

More News

Highlights

Bailey, Eisenberg , and Fomby promoted at PSC

Former PSC trainee Eric Chyn wins PAA's Dorothy S. Thomas Award for best paper

Celebrating departing PSC trainees

Bloome finds children raised outside stable 2-parent families more likely to become low-income adults, regardless of parents' income

More Highlights

Evaluating Policies for Improving Surgical Care in the Elderly

a PSC Research Project [ARCHIVE DISPLAY]

Investigators:   Justing Dimick, Nicholas Osborne

Each year in the United States, more than 50,000 Medicare patients die undergoing inpatient surgery. Evidence of wide variations across providers suggests substantial room for improvement. To improve surgical care in the elderly, the Center for Medicare and Medicaid Services (CMS) has launched several policies. However, the extent to which these policies improve outcomes and reduce costs in surgery is unknown. We therefore propose a systematic evaluation of the impact of several policy options on the quality and cost of surgical care in the national Medicare population. With this goal in mind, our current proposal has the following aims: Aim 1. To evaluate the impact of CMS improvement policies on surgical outcomes. We will conduct evaluations of pay-for-performance, selective referral, bundled payment, and outcomes feedback in the national Medicare population. For each policy approach, we will take advantage of a natural experiment (i.e., a specific program or policy implemented in the last 5 years). To assess outcomes, we will use risk-adjusted mortality and complications for the procedures specifically targeted by the policy. To better control for hospital case-mix and secular trends, we will use a difference-in-difference methodology. Aim 2. To evaluate the spillover effects of these CMS policies on untargeted surgical conditions. Using national Medicare data, we will examine outcomes for untargeted procedures for which patients receive care from the same surgeons or depend on the same hospital resources. We will assess whether these policies resulted in beneficial spillover effects or caused unintended harm as resources were diverted to the targeted conditions. Aim 3. To evaluate the impact of these policies on Medicare payments around the surgical episode. We will evaluate Medicare payments for the full range of services that can be linked to complications and poor quality care. We will include payments to the hospital, physicians, readmissions, and post-acute care. The results of this study will facilitate evidence-based policymaking by CMS and other payers. As effective policies for improving care are implemented, surgical patients will be the ultimate beneficiaries of this research.

Funding Period: 04/15/2011 to 06/30/2016

Country of Focus: USA

This PSC Archive record is displayed for historical reference.

Search . Browse