Evidence map›Paper›PMID 34580082›Full record

ArticleBMJ open quality2021

Cost-DALY comparison of hip replacement care in 12 Belgian hospitals.

Fabian Dehanne, Maximilien Gourdin, Brecht Devleesschauwer, Benoit Bihin, Philippe Van Wilder, Bertrand Mareschal, Pol Leclercq, Magali Pirson

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Fabian DehanneGeneral Management, CHU UCL Namur, Yvoir, Belgium fabian.dehanne@uclouvain.be.
Maximilien GourdinGeneral Management, CHU UCL Namur, Yvoir, Belgium.
Brecht DevleesschauwerDepartment of Epidemiology and Public Health, Sciensano, Brussel, Belgium.
Benoit BihinGeneral Management, CHU UCL Namur, Yvoir, Belgium.
Philippe Van WilderESP, ULB, Bruxelles, Belgium.
Bertrand MareschalULB - Solbosch Campus, Bruxelles, Belgium.
Pol LeclercqESP, ULB, Bruxelles, Belgium.
Magali PirsonESP, ULB, Bruxelles, Belgium.
CHU Dinant Godinne UCL Namur · BESciensano (Belgium) · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn view of the expected increase in expenditure on hip replacement treatment in Belgium, the complication rate and potential waste reduction, as estimated by the Organisation for Economic Cooperation and Development, we are not yet in a position to assess the efficiency of hip replacement treatment in Belgian hospitals. This objective study uses a cost-disability-adjusted life years (DALYs) ratio to propose a comparison of hip replacement surgery among 12 Belgian hospitals.

methodsOur study seeks to innovate by proposing an interhospital comparison that simultaneously integrates the weighting of quality indicators and the costs of managing a patient. To this end, we associated a DALY impact with each patient safety indicator, readmission and mortality outcome. We then compared hospitals using both costs and DALYs adjusted to their case mix index. The adjusted values (costs and DALYs) were obtained by relating the observed value to the predicted value obtained from the linear regression model.

resultsWe registered a total of 246.5 DALYs for the 12 hospital institutions, the average cost (SD) of a stay being €8013 (€4304). Our model allowed us to identify hospitals with observed values higher than those predicted. Out of the 12 hospitals evaluated, 4 need to reduce costs and DALYs impacts, 6 have to improve one of the two factors and 2 appear to have good results. The costs for the worst performing hospitals can rise to over €150 000.

conclusionEvaluating the rates of patient safety indicators, associated with cost, is a prerequisite for quality and cost improvement efforts on the part of managers and practitioners. However, it appears essential to evaluate the entire care chain using a comparable unit of measurement. The hospital's case mix index must also be considered in benchmarking to avoid drawing the wrong conclusions. In addition, other indicators, such as the patient's perception of the actual results, should be added to our study.

Indexed as

Arthroplasty, Replacement, HipHospitalsBelgiumCosts and Cost AnalysisHumansQuality-Adjusted Life Yearsefficiencyevaluation methodologyhealthcare quality improvementorganisationalpatient safetypay for performance

Identifiers

PMID34580082
PMCPMC8477339
OpenAlexW3202674461

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.