Incremental Consequences of Inpatient Medical Injuries: Heart Failure Treatment

Quantros Value-based Care Factoid: November 2017
Powered by the world’s largest real-world evidence base on patient safety and healthcare quality, the Quantros Value-based Care Factoid Series provides informative indicators and measures of clinical and financial performance that matter in value-based reimbursement and payment models.

Delivered in partnership with Becker’s Hospital Review, we are confident these research insights and greater transparency will help all stakeholders to accurately measure and benchmark progress on the journey to value-based, higher-quality and safer care. To read the rest of the series of factoids, click here.

Incremental Consequences of Inpatient Medical Injuries: Heart Failure Treatment

Heart failure (HF) is a prevalent and costly disease that affects approximately 6.5 million U.S. adults. Total direct medical costs of HF were estimated to be $21 billion in 2012 and projected to increase to $53 billion by 2030. The majority of those costs are contributed by HF patients age 65 and over – 81% of total HF costs in 2012 and projected to rise to 88% by 2030.¹

Using the 2018 CareChex National Quality Ratings Database (NQRD) which incorporates ten (10) quarters of Medicare Fee for Service (FFS) claims data (January 2014 to June 2016) and includes virtually all general, acute, non-federal U.S. hospitals (+/- 4,500), Quantros analyzed the incremental consequences of selected inpatient medical injuries and preventable adverse events in terms of excess charges, excess costs, excess mortality, and excess days of care among patients treated for Heart Failure (DRG 291, 292 and 293), accounting for differences in patient severity, intensity, and complexity. Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSI) and associated methodologies were used to identify selected medical and surgical injuries. PSIs are a set of indicators providing information on potential in hospital complications and adverse events following surgeries, procedures, and childbirth.

Amongst all of the top-ranked CareChex hospitals by state for Patient Safety in Heart Failure Treatment, PSI-13 (Postoperative Sepsis rate) was identified as the highest contributor of excess charges, excess costs and excess days of care during the performance period (January 2014 through June 2016).

Source: 2018 CareChex® Hospital & Health System Quality Ratings Database
(Data Time Period: January 2014 – June 2016)

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¹Heidenreich PA, Albert NM, Allen LA, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fall. 2013;6(3):606-619