{"id":234,"date":"2017-05-01T14:38:21","date_gmt":"2017-05-01T18:38:21","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-mhcdsolutions\/submission\/risk-reduction-in-elective-surgeries\/"},"modified":"2017-05-01T14:39:21","modified_gmt":"2017-05-01T18:39:21","slug":"risk-reduction-in-elective-surgeries","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/submission\/risk-reduction-in-elective-surgeries\/","title":{"rendered":"Risk reduction in elective surgeries"},"content":{"rendered":"

Few would disagree that patient health should be optimized prior to elective surgery to decrease complication rates.\u00a0 In the United States there is a well intentioned movement to increase public reporting of complication and readmission rates around elective surgeries (by hospital, not by surgeon as of yet).\u00a0 In addition,\u00a0hospitals may be financially penalized for readmissions and complications in the future.<\/p>\n

Some risk factors for complications and readmissions\u00a0such as diabetes control, weight loss, coronary artery disease optimization and smoking cessation can be very difficult to optimize.<\/p>\n

Making hospitals responsible for complication rates from a financial and public reporting standpoint is conceptually an excellent idea.\u00a0 However the danger is that this may limit access to care for sicker patients, as hospitals become more concerned about complication risk.\u00a0 \u00a0Risk adjusted outcome scoring can be used for challenging patients, but it is difficult to assign a cumulative risk for patients with multiple medical co-morbidities.<\/p>\n

Some health systems have taken an alternative approach and have gone so far as to place hard stops for elective surgery. For instance as I understand it the National Health System in the United Kingdom currently\u00a0limits elective hip and knee replacement to patients with a body mass index under 35 kg\/m2.<\/p>\n

What is the best way to incentivize the improvement in health of patients prior to elective surgery; 1. front end rules or guidelines limiting surgery to patients who meet certain criteria, or 2.\u00a0 back end financial and public relations incentives to drive a reduction in negative outcomes.\u00a0 Or we are certainly open to option 3…….<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Incentivizing risk reduction for elective procedures.<\/p>\n","protected":false},"author":9165,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","categories":[],"class_list":["post-234","hck-submission","type-hck-submission","status-publish","hentry"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/conversation\/mhcd-solutions-ii\/","yoast_head":"\nRisk reduction in elective surgeries - Managing Health Care Delivery<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/submission\/risk-reduction-in-elective-surgeries\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Risk reduction in elective surgeries - Managing Health Care Delivery\" \/>\n<meta property=\"og:description\" content=\"Incentivizing risk reduction for elective procedures.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/submission\/risk-reduction-in-elective-surgeries\/\" \/>\n<meta property=\"og:site_name\" content=\"Managing Health Care Delivery\" \/>\n<meta property=\"article:modified_time\" content=\"2017-05-01T18:39:21+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/d3.harvard.edu\\\/platform-mhcdsolutions\\\/submission\\\/risk-reduction-in-elective-surgeries\\\/\",\"url\":\"https:\\\/\\\/d3.harvard.edu\\\/platform-mhcdsolutions\\\/submission\\\/risk-reduction-in-elective-surgeries\\\/\",\"name\":\"Risk reduction in elective surgeries - 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