Did case-based payment influence surgical readmission rates in France? A retrospective study - INRAE - Institut national de recherche pour l’agriculture, l’alimentation et l’environnement Accéder directement au contenu
Article Dans Une Revue BMJ Open Année : 2018

Did case-based payment influence surgical readmission rates in France? A retrospective study

Résumé

OBJECTIVES: To determine whether implementation of a case-based payment system changed all-cause readmission rates in the 30 days following discharge after surgery, we analysed all surgical procedures performed in all hospitals in France before (2002-2004), during (2005-2008) and after (2009-2012) its implementation. SETTING: Our study is based on claims data for all surgical procedures performed in all acute care hospitals with >300 surgical admissions per year (740 hospitals) in France over 11 years (2002-2012; n=51.6 million admissions). INTERVENTIONS: We analysed all-cause 30-day readmission rates after surgery using a logistic regression model and an interrupted time series analysis. RESULTS: The overall 30-day all-cause readmission rate following discharge after surgery increased from 8.8% to 10.0% (P<0.001) for the public sector and from 5.9% to 8.6% (P<0.001) for the private sector. Interrupted time series models revealed a significant linear increase in readmission rates over the study period in all types of hospitals. However, the implementation of case-based payment was only associated with a significant increase in rehospitalisation rates for private hospitals (P<0.001). CONCLUSION: In France, the increase in the readmission rate appears to be relatively steady in both the private and public sector but appears not to have been affected by the introduction of a case-based payment system after accounting for changes in care practices in the public sector.
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hal-02617721 , version 1 (25-05-2020)

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Paternité - Pas d'utilisation commerciale

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Albert Vuagnat, Engin Yilmaz, Adrien Roussot, Victor Rodwin, Maryse Gadreau, et al.. Did case-based payment influence surgical readmission rates in France? A retrospective study. BMJ Open, 2018, 8 (2), pp.e018164. ⟨10.1136/bmjopen-2017-018164⟩. ⟨hal-02617721⟩
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