Our Summary

This research aimed to evaluate the effectiveness of a shared savings program for children who had undergone an appendectomy (surgery to remove the appendix). The program was assessed based on four quality targets: reducing the time to surgery by 15%, reducing the length of hospital stay, lowering the rate of readmission to the hospital, and improving patient satisfaction. Two time periods were studied and compared to a baseline period. The study involved 640 patients.

During the first study period, none of the four quality targets were achieved. In the second period, two targets were met: the rate of readmission to the hospital decreased by 57% and patient satisfaction improved. However, the program did not result in any cost savings because the cost of care did not decrease by the required 9%.

The study concluded that partnerships between healthcare providers and payers (those who pay for healthcare, usually insurance companies) can be a good way to test new models of payment based on the value of care provided. However, it highlighted several factors that should be considered in future programs, such as setting realistic targets, identifying quality measures that can be influenced, taking into account the complexity of cases, and allowing enough time for cost-saving measures to take effect.

FAQs

  1. What was the aim of the shared savings program for pediatric appendectomy?
  2. What were the quality targets set for the shared savings program and what were the results?
  3. What conclusions were drawn from the study on shared savings program for pediatric appendectomy?

Doctor’s Tip

One helpful tip a doctor might give a patient about pediatric appendectomy is to follow post-operative care instructions carefully to ensure a smooth recovery. This may include taking prescribed medications, avoiding strenuous activities, and following up with the surgeon for any concerns or complications. Additionally, maintaining a healthy diet and staying hydrated can also aid in the healing process.

Suitable For

Pediatric patients who are recommended for appendectomy typically have symptoms such as abdominal pain, nausea, vomiting, and fever, which may indicate appendicitis. These patients may also have elevated white blood cell count and imaging studies showing inflammation of the appendix. Additionally, patients who have recurrent episodes of abdominal pain and have a history of previous appendicitis may also be recommended for pediatric appendectomy. It is important for these patients to undergo surgery promptly to prevent complications such as perforation of the appendix.

Timeline

Before pediatric appendectomy:

  • Patient experiences abdominal pain, often starting near the belly button and eventually moving to the lower right side
  • Patient may also experience loss of appetite, nausea, vomiting, and low-grade fever
  • Patient visits a healthcare provider who performs a physical examination and may order imaging tests such as ultrasound or CT scan to confirm the diagnosis
  • Surgery is scheduled for the removal of the inflamed appendix

After pediatric appendectomy:

  • Patient undergoes surgery to remove the inflamed appendix, typically done laparoscopically
  • Patient stays in the hospital for a few days for monitoring and recovery
  • Patient may experience some pain and discomfort after surgery, which can be managed with pain medication
  • Patient is discharged from the hospital once they are able to tolerate food, drink, and pass gas
  • Patient is advised to rest and avoid strenuous activities for a few weeks
  • Patient follows up with their healthcare provider for post-operative care and monitoring of the surgical site.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric appendectomy?
  2. How will the timing of the surgery be determined and what factors will influence this decision?
  3. What is the expected length of hospital stay for a pediatric appendectomy?
  4. How will pain management be handled post-surgery?
  5. What follow-up care or monitoring will be necessary after the procedure?
  6. How will the success of the appendectomy be measured in terms of outcomes and patient satisfaction?
  7. Are there any alternative treatment options or approaches that could be considered for pediatric appendicitis?
  8. How will the cost of the procedure be covered and are there any financial assistance options available?
  9. What experience does the healthcare provider have with performing pediatric appendectomies?
  10. How will the healthcare provider work with the patient and their family to ensure a positive outcome and recovery from the surgery?

Reference

Authors: Yu YR, Mehl SC, Carberry KE, Ren H, Barclay C, Patel B, Nuchtern JG, Lopez ME. Journal: Am J Surg. 2022 Jan;223(1):106-111. doi: 10.1016/j.amjsurg.2021.07.017. Epub 2021 Jul 24. PMID: 34364653