Comparing financing models for supplementary healthcare in appendectomy: activity-based costing (fee-for-service) vs. diagnosis related group remuneration (bundled payment): a systematic review and meta-analysis
Acta cir. bras
;
38: e386923, 2023. tab, graf, ilus
Article
in English
| LILACS, VETINDEX
| ID: biblio-1527585
ABSTRACT
Purpose:
In Brazil, healthcare services traditionally follow a fee-for-service (FFS) payment system, in which each medical procedure incurs a separate charge. An alternative reimbursement with the aim of reducing costs is diagnosis related group (DRG) remuneration, in which all patient care is covered by a fixed amount. This work aimed to perform a systematic review followed by meta-analysis to assess the effectiveness of the Budled Payment for Care Improvement (BPCI) versus FFS.Methods:
Our work was performed following the items of the PRISMA report. We included only observational trials, and the primary outcome assessed was the effectiveness of FFS and DRG in appendectomy considering complications. We also assessed the costs and length of hospital stay. Meta-analysis was performed with Rev Man version 5.4.Results:
Out of 735 initially identified articles, six met the eligibility criteria. We demonstrated a shorter hospital stay associated with the DRG model (mean difference = 0.39; 95% confidence interval 95%CI 0.380.40; p < 0.00001; I2 = 0%), however the hospital readmission rate was higher in this model (odds ratio = 1.57; 95%CI 1.022.44, p = 0.04; I2 = 90%).Conclusions:
This study reveals a potential decrease in the length of stay for appendectomy patients using the DRG approach. However, no significant differences were observed in other outcomes analysis between the two approaches.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Appendectomy
/
Healthcare Financing
/
Health Services Accessibility
Type of study:
Diagnostic study
/
Health economic evaluation
/
Prognostic study
/
Systematic reviews
Language:
English
Journal:
Acta cir. bras
Journal subject:
General Surgery
/
Procedimentos Cir£rgicos Operat¢rios
Year:
2023
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de São Paulo/BR
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