Surgical procedures in inpatient versus outpatient settings and its potential impact on follow-up costs

Brüngger, Beat and Bähler, Caroline and Schwenkglenks, Matthias and Ulyte, Agne and Dressel, Holger and von Wyl, Viktor and Gruebner, Oliver and Wei, Wenjia and Serra-Burriel, Miquel and Blozik, Eva. (2021) Surgical procedures in inpatient versus outpatient settings and its potential impact on follow-up costs. Health policy (Amsterdam, Netherlands), 125 (10). pp. 1351-1358.

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Official URL: https://edoc.unibas.ch/86988/

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We examined real-world effects of cantonal legislations to direct surgery patients from the inpatient to the outpatient setting in Switzerland.; Analyses were based on claims data of the Helsana Group, a leading Swiss health insurance. The study population consisted of 13'145 (in 2014), 12'455 (in 2016), and 12'875 (in 2018) insured persons aged >18 years who had haemorrhoidectomy, inguinal hernia repair, varicose vein surgery, knee arthroscopy/meniscectomy or surgery of the cervix/uterus. We assessed the proportion of inpatient procedures, index costs, length of hospital stays, outpatient costs and hospitalizations during follow-up, stratified by procedure, in-/outpatient setting, and the presence (enacted/effective in 2018) of a cantonal legislation. We used difference-in-differences methods to study the impact of cantonal legislations.; Overall, the proportion of procedures performed in the inpatient setting decreased between 2014 and 2018 (p < 0.001). The decrease between 2016 and 2018 was significantly steeper in cantons with a legislation (p < 0.001; effect size: 0.57; 95% CI: 0.51, 0.64), leading to steeper decreases in healthcare costs of index procedures in cantons with a legislation, with no impact on length of hospital stays. The legislation also had no impact on outpatient costs or hospitalizations during follow-up.; The cantonal legislations achieved the intended effects of inpatient surgery substitution by outpatient surgery, with no evidence suggesting negative effects on costs or hospitalizations during follow-up.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Pharmazeutische Medizin ECPM > Pharmazeutische Medizin (Szucs)
UniBasel Contributors:Schwenkglenks, Matthias
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:10 Feb 2022 18:11
Deposited On:10 Feb 2022 18:11

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