医疗保险人群中髋部和骨盆骨折的骨科创伤计费及报销的地域差异。
Geographic variations in orthopedic trauma billing and reimbursements for hip and pelvis fractures in the Medicare population.
作者信息
Dodd Ashley C, Lakomkin Nikita, Bulka Catherine, Thakore Rachel, Collinge Cory A, Sethi Manish K
机构信息
The Vanderbilt Orthopaedic Institute Center for Health Policy, 1215 21st Ave S, Suite 4200, Medical Center East-South Tower, Nashville, TN 37232, United States.
出版信息
J Orthop. 2016 Jun 25;13(4):264-7. doi: 10.1016/j.jor.2016.06.015. eCollection 2016 Dec.
We investigated geographic variations in Medicare spending for DRG 536 (hip and pelvis fracture). We identified 22,728 patients. The median number of charges, discharges, and payments were recorded. Hospitals were aggregated into core based statistical (CBS) areas and the coefficient of variation (CV) was calculated for each area. On average, hospitals charged 3.75 times more than they were reimbursed. Medicare charges and reimbursements demonstrated variability within each area. Geographic variation in Medicare spending for hip fractures is currently unexplained. It is imperative for orthopedists to understand drivers behind such high variability in hospital charges for management of hip and pelvis fractures.
我们调查了医疗保险预付费制度（DRG）536（髋部和骨盆骨折）的医保支出地理差异。我们确定了22728名患者。记录了收费、出院人数和支付金额的中位数。医院被汇总到基于核心的统计区域（CBS），并计算每个区域的变异系数（CV）。平均而言，医院的收费是报销金额的3.75倍。医保收费和报销在每个区域内都存在差异。目前，髋部骨折医保支出的地理差异尚无法解释。骨科医生必须了解髋部和骨盆骨折治疗中医院收费如此高差异背后的驱动因素。
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