Roadmap for Succeeding in Bundled Payment for Orthopedic Joint Replacements
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 主要终点
- Surgical site infection at the physician level
研究概览
简要总结
The objective of the study is to provide a road map that can help organizational leaders understand how to sequence their financial and human capital investments related to bundled payment arrangements. Although specific strategies will vary between organizations, providing evidence from a health system with extension experience bundling care for orthopedic joint replacements can be instructive for other providers entering new building arrangements. Insights from the experience of the health system can help other organizations prioritize effort and focus energy around strategies that increase the likelihood of succeeding under Comprehensive Care for Joint Replacement (CJR) and other bundled payment contracts.
详细描述
This study will analyze data from a health system with the longest standing experience with bundled payments for orthopedic procedures. The goal of this work is to provide insights from this health system's six years of experience and offer a road map that other organizations around the country can use as they plan and implement their own bundled payment programs. The investigators will conduct a retrospective analysis on quality and cost data from a health system with extensive experience with bundled payments for orthopedic joint replacements. The study design will consist of three parts: first, the team will report trends in quality and cost outcomes over time using descriptive statistics; second, the team will perform multi-variable regression analyses on the data to identify significant predictors of different quality and cost outcomes and provide statistical tests on the trends; third, the team will evaluate changes in physician and hospital level variation along the outcomes.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Retrospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •participants in this study will be physicians participating in the bundled payment arrangement at the health system in question. All physicians will be included in the analysis.
排除标准
- •no exclusion criteria
结局指标
主要结局
Surgical site infection at the physician level
时间窗: 12 months
The study team will evaluate at the physician level. The quality metric evaluated will be average rate of surgical site infections.
次要结局
- All-cause readmission rate at the physician level(12 months)
- Cost of care during hospitalization(12 months)
- Spending at the physician level(12 months)
- Cost of care post-discharge(12 months)
- Venous thromboembolism at the physician level(12 months)
- Cost of care at the physician level(12 months)
研究者
Amol Navathe
MD, PHD
University of Pennsylvania