Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Evaluation of the impact of prospective payment systems on cholecystectomy: A systematic review and meta-analysis

  • Yun Zhao (Group Finance Analytics, Singapore Health Services) ;
  • Ivan En-Howe Tan (Group Finance Analytics, Singapore Health Services) ;
  • Vikneswary D/O A Jahnasegar (School of Economics, Singapore Management University) ;
  • Hui Min Chong (Group Finance Analytics, Singapore Health Services) ;
  • Yonghui Chen (Group Finance Analytics, Singapore Health Services) ;
  • Brian Kim Poh Goh (Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore) ;
  • Marianne Kit Har Au (Group Finance Analytics, Singapore Health Services) ;
  • Ye Xin Koh (Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore)
  • Received : 2024.02.13
  • Accepted : 2024.04.01
  • Published : 2024.08.31
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Abstract

This systematic review and meta-analysis aimed to evaluate the impact of prospective payment systems (PPSs) on cholecystectomy. A comprehensive literature review was conducted, examining studies published until December 2023. The review process focused on identifying research across major databases that reported critical outcomes such as length of stay (LOS), mortality, complications, admissions, readmissions, and costs following PPS for cholecystectomy. The studies were specifically selected for their relevance to the impact of PPS or the transition from fee-for-service (FFS) to PPS. The study analyzed six papers, with three eligible for meta-analysis, to assess the impact of the shift from FFS to PPS in laparoscopic and open cholecystectomy procedures. Our findings indicated no significant changes in LOS and mortality rates following the transition from FFS to PPS. Complication rates varied and were influenced by the diagnosis-related group categorization and surgeon cost profiles under episode-based payment. There was a slight increase in admissions and readmissions, and mixed effects on hospital costs and financial margins, suggesting varied responses to PPS for cholecystectomy procedures. The impact of PPS on cholecystectomy is nuanced and varies across different aspects of healthcare delivery. Our findings indicate a need for adaptable, patient-centered PPS models that balance economic efficiency with high-quality patient care. The study emphasizes the importance of considering specific surgical procedures and patient demographics in healthcare payment reforms.

Keywords

References

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