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Variación y impulsores del gasto dentro de los episodios de cuidado basados en el departamento de emergencias de 30
Keith E Kocher1,2,3,4, Alexander T Janke5,6, Kristen P Hassett7
1Department of Emergency Medicine, School of Medicine, University of Michigan, Ann Arbor, MI, USA. kkocher@umich.edu.
Journal of general internal medicine
|February 11, 2026
Resumen
Las visitas al departamento de emergencias (ED) para la insuficiencia cardíaca congestiva (ICC), la enfermedad pulmonar obstructiva crónica (EPOC) y la neumonía muestran una variación significativa en el gasto en los hospitales. Esta variación se debe principalmente a los costos asociados con la visita inicial de urgencias y las hospitalizaciones posteriores.
Área de la Ciencia:
- Servicios de salud Servicios de salud Investigación Investigación.
- Economía de la salud Economía de la salud
- Las operaciones clínicas son operaciones clínicas.
Sus antecedentes:
- Las visitas al departamento de emergencias (ED) son un punto de entrada crítico para la atención aguda, que influye en los resultados de los pacientes y los costos de atención médica.
- Los modelos actuales de atención médica rara vez definen episodios de atención basados en encuentros iniciales con ED.
- Comprender el gasto en episodios basados en la disfunción eréctil es crucial para mejorar la calidad y la eficiencia de la atención médica.
Objetivo del estudio:
- Analizar las variaciones a nivel hospitalario en el gasto para los episodios de 30 días de atención iniciados en la ED.
- Identificar los factores clave de esta variación en el gasto para la insuficiencia cardíaca congestiva (ICC), la enfermedad pulmonar obstructiva crónica (EPOC) y la neumonía.
- Proporcionar información sobre áreas potenciales de ahorro de costos y mejora de la calidad.
Principales métodos:
- Se realizó un estudio transversal basado en reclamos en el que participaron 83 hospitales de Michigan.
- Los datos incluyeron pacientes adultos diagnosticados con CHF, EPOC o neumonía entre 2017 y 2022.
- Se analizaron los pagos de episodios basados en ED de 30 días totales y componentes ajustados al riesgo y estandarizados por precio.
Principales resultados:
- Se observaron variaciones significativas en los pagos a nivel hospitalario para CHF (24,7%), EPOC (33,1%) y neumonía (31,9%).
- El gasto más alto se correlacionó fuertemente con el aumento de los costos durante la visita y la hospitalización del índice ED.
- La atención post-aguda y los honorarios profesionales también contribuyeron a las disparidades de pago, con un impacto variable en las condiciones.
Conclusiones:
- Existe una variación sustancial en los pagos de episodios basados en ED de 30 días para CHF, EPOC y neumonía en los hospitales.
- Los principales impulsores de esta variación son los costos incurridos durante la visita inicial de urgencias y las hospitalizaciones asociadas.
- Se necesita más investigación para determinar si estas diferencias de gasto reflejan variaciones en la calidad de la atención o la eficiencia operativa.
Palabras clave:
Modelos de pago alternativos para el pago.Departamento de emergencias del departamento de emergencias.Episodio de cuidado en el cuidado.Medicina del hospital Medicina del hospital Medicina del hospitalcalidad de calidad calidad calidad calidad.Más Videos Relacionados
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