Variations in Cost and Readmissions of Patients in the Bundled Payment for Care Improvement Bundle for Hip and Femur Fractures

Introduction The Bundled Payment for Care Improvement (BPCI) for hip and femur fractures is an effort to increase care quality and coordination at a lower cost. The bundle includes all patients undergoing an operative fixation of a hip or femur fracture (diagnosis-related group codes 480-482). This...

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Bibliographic Details
Published in:Geriatric orthopaedic surgery & rehabilitation Vol. 12; p. 21514593211049664
Main Authors: Rose, Ryan Hunter, Cherney, Steven M., Jensen, Hanna K., Karim, Saleema A., Mears, Simon C.
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 2021
Sage Publications Ltd
SAGE Publishing
Subjects:
Fractures
Hospital costs
Length of stay
Medical Student Corner
hospital cost
readmission rate
hip fracture
femur fracture
bundled payment
ISSN:2151-4593, 2151-4585, 2151-4593
Online Access:Get full text
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Summary:Introduction The Bundled Payment for Care Improvement (BPCI) for hip and femur fractures is an effort to increase care quality and coordination at a lower cost. The bundle includes all patients undergoing an operative fixation of a hip or femur fracture (diagnosis-related group codes 480-482). This study aims to investigate variance in the hospital cost and readmission rates for patients within the bundle. Materials and Methods The study is a retrospective analysis of patients ≥65 years old billed for a diagnosis-related groups 480-482 in 2016 in the National Readmission Database. Cost of admission and length of stay were compared between patients who were or were not readmitted. Regression analysis was used to determine the effects of the primary procedure code and anatomical location of the femur fracture on costs, length of stay, and readmission rates. Results Patients that were readmitted within 90 days of surgery had an increased cost on initial admission ($18,427 vs $16,844, P < .0001), and an increased length of stay (6.24 vs 5.42, P < .0001). When stratified by procedure, patients varied in readmission rates (20.7% vs 19.6% vs 21.8%), initial cost, and length of stay (LOS). Stratification by anatomical location also led to variation in readmission rates (20.7% vs 18.3% vs 20.6%), initial cost, and LOS. Conclusion The hip and femur fractures bundle includes a great number of procedures with variance in cost, readmission, and length of stay. This amount of variation may make standardization difficult and may put the hospital at potential financial risk.
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ISSN:2151-4593
2151-4585
2151-4593
DOI:10.1177/21514593211049664