Medical tourism might affect post-surgical complications

Medicare beneficiaries that need to return to the hospital following a serious surgery typically fare better if they return to the hospital where the original procedure was performed, known as the index hospital. This information may have an impact on “medical tourism,” in which companies encourage employees to travel to certain medical centers that will perform surgeries for lower, negotiated rates.

According to a study, patients receiving follow up treatment at the index hospital saw a 26 percent lower risk of 90 day mortality. From the cases studied, the numbers ranged from 65.8 percent of patients requiring additional treatment following a coronary artery bypass grafting to 83.2 percent following a colectomy being readmitted or transferred back to the index hospital as opposed to remaining at a non-index hospital.

Methods

The study involved claims data from 9,440,503 Medicare beneficiaries who underwent one of 12 major operations between January 1, 2001 and November 15, 2011 and sought hospital readmission within 30 days of the procedure. The surgeries involved were open abdominal aortic aneurysm repair, infrainguinal arterial bypass, aortobifemoral bypass, coronary artery bypass surgery, oesophagectomy, colectomy, pancreatectomy, cholecystectomy, ventral hernia repair, craniotomy, hip replacement, or knee replacement.

Tourism

The data showed that readmission to an index hospital was more likely, by 10 percent, if it was due to a surgical complication. For medical tourism patients, however, this is more difficult to achieve if they were required to travel long distances to the destination hospitals. According to the lead author of the study, Dr. Benjamin Brooke, between 5 to 22 percent of patients were readmitted, based on the type of surgery. Improved survival outcomes were associated with both large teaching hospitals and small community hospitals. Despite the fact that the study involved patients of retirement age that were unlikely to be part of a company’s medical tourism program, Dr. Sam Finlayson, a senior author of the study, felt that the results warranted consideration from anyone undergoing a major procedure.