CREATING A “VALUE INDEX”: A METHOD TO COMPARE REGIONAL PROGRAMS PERFORMING CONGENITAL HEART SURGERY

Authors

  • S. Adil Husain S. Adil Husain, MD, is Chief of the Division of Pediatric Cardiothoracic Surgery, in the Department of Cardiothoracic Surgery, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.
  • M. Sajed Rahman M. Sajed Rahman, Ph.D., is an Assistant Professor in the Department of Accounting & Information Systems, School of Business, Emporia State University, Emporia, Kansas.
  • Clinton E. Baisden Clinton E. Baisden, MD, is former Clinical Professor and Director of Cardiothoracic Research Division, in the Department of Cardiothoracic Surgery, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.
  • Dana A. Forgione Dana A. Forgione Ph.D., CPA, CMA, CFE, is the Janey S. Briscoe Endowed Chair in the Business of Health, and a Professor of Accounting, in the College of Business, University of Texas at San Antonio, in San Antonio, Texas.
  • Lauren C. Kane Lauren C. Kane, MD, holds a joint academic appointment of Assistant Professor in the Department of Cardiothoracic Surgery and the Department of Pediatrics, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.
  • Steven R. Neish Steven R. Neish, MD, SM, is Vice Chairman of the Department of Pediatrics, in the School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.
  • John H. Calhoon John H. Calhoon, MD, is Professor and Chair of the Department of Cardiothoracic Surgery, and the President's Council Chair for Excellence in Surgery, in the School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

Abstract

Resource allocation challenges persist among surgical programs in the U.S. As healthcare policy moves increasingly toward value-based approaches, models to assist in comparing and evaluating programs become increasingly important. We used the Texas Hospital Inpatient Discharge Database to develop such a model. We included all patients under one year old, with primary surgical procedural codes for Total Anomalous Pulmonary Venous Connection, Transposition of the Great Arteries, and Tetralogy of Fallot (a congenital heart defect where not enough blood is able to reach the lungs to get oxygen). We examined mortality, length of stay, and total hospital charges data from January 2005 to June 2010. We used scatter plots to place programs into value quartiles. Three of the 11 surgical programs we identified appeared within the quartile of high-survival with low-charges and were identified as having high value. We performed additional risk-adjustment modeling and treatment pattern evaluation, and such information will have great importance for regional care planning.

Author Biographies

  • S. Adil Husain, S. Adil Husain, MD, is Chief of the Division of Pediatric Cardiothoracic Surgery, in the Department of Cardiothoracic Surgery, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

    S. Adil Husain, MD, is Chief of the Division of Pediatric Cardiothoracic Surgery, in the Department of Cardiothoracic Surgery, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

  • M. Sajed Rahman, M. Sajed Rahman, Ph.D., is an Assistant Professor in the Department of Accounting & Information Systems, School of Business, Emporia State University, Emporia, Kansas.

    M. Sajed Rahman, Ph.D., is an Assistant Professor in the Department of Accounting & Information Systems, School of Business, Emporia State University, Emporia, Kansas.

  • Clinton E. Baisden, Clinton E. Baisden, MD, is former Clinical Professor and Director of Cardiothoracic Research Division, in the Department of Cardiothoracic Surgery, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

    Clinton E. Baisden, MD, is former Clinical Professor and Director of Cardiothoracic Research Division, in the Department of Cardiothoracic Surgery, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

  • Dana A. Forgione, Dana A. Forgione Ph.D., CPA, CMA, CFE, is the Janey S. Briscoe Endowed Chair in the Business of Health, and a Professor of Accounting, in the College of Business, University of Texas at San Antonio, in San Antonio, Texas.

    Dana A. Forgione Ph.D., CPA, CMA, CFE, is the Janey S. Briscoe Endowed Chair in the Business of Health, and a Professor of Accounting, in the College of Business, University of Texas at San Antonio, in San Antonio, Texas.

  • Lauren C. Kane, Lauren C. Kane, MD, holds a joint academic appointment of Assistant Professor in the Department of Cardiothoracic Surgery and the Department of Pediatrics, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

    Lauren C. Kane, MD, holds a joint academic appointment of Assistant Professor in the Department of Cardiothoracic Surgery and the Department of Pediatrics, School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

  • Steven R. Neish, Steven R. Neish, MD, SM, is Vice Chairman of the Department of Pediatrics, in the School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

    Steven R. Neish, MD, SM, is Vice Chairman of the Department of Pediatrics, in the School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

  • John H. Calhoon, John H. Calhoon, MD, is Professor and Chair of the Department of Cardiothoracic Surgery, and the President's Council Chair for Excellence in Surgery, in the School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

    John H. Calhoon, MD, is Professor and Chair of the Department of Cardiothoracic Surgery, and the President's Council Chair for Excellence in Surgery, in the School of Medicine, University of Texas Health Science Center San Antonio, in San Antonio, Texas.

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Published

2015-09-12

Issue

Vol. 42 No. 2: Fall 2015

Section

Articles