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Implementation of the Maryland Global Budget Revenue Model and Variation in the Expenditures and Outcomes of Surgical Care: A Systematic Review and Meta-analysis.

Publication ,  Journal Article
Shammas, RL; Coroneos, CJ; Ortiz-Babilonia, C; Graton, M; Jain, A; Offodile, AC
Published in: Annals of surgery
April 2023

To assess the effect of the Global Budget Revenue (GBR) program on outcomes after surgery.There is limited data summarizing the effect of the GBR program on surgical outcomes as compared with traditional fee-for-service systems.The Medline, Embase, Scopus, and Web of Science databases were used to conduct a systematic literature search on April 5, 2022. We identified full-length reports of comparative studies involving patients who underwent surgery in Maryland after implementation of the GBR program. A random effects model calculated the overall pooled estimate for each outcome which included complications, rates of readmission and mortality, length of stay, and costs.Fourteen studies were included in the qualitative synthesis, with 8 unique studies included in the meta-analysis. Our analytical sample was comprised of 170,011 Maryland patients, 78,171 patients in the pre-GBR group, and 91,840 patients in the post-GBR group. The pooled analysis identified modest reductions in costs [standardized mean difference (SMD) -0.34; 95% CI, -0.42, -0.25; P <0.001], complications [odds ratio (OR): 0.57; 95% CI, 0.36-0.92, P =0.02], readmission (OR: 0.78; 95% CI, 0.72-0.85, P <0.001), mortality (OR: 0.58; 95% CI, 0.47-0.72, P <0.001), and length of stay (standardized mean difference: -0.26; 95% CI, -0.32, -0.2, P <0.001) after surgery.Implementation of the GBR program is associated with improved outcomes and reductions in costs among Maryland patients who underwent surgical procedures. This is particularly salient given the increasing need to disseminate and scale population-based payment models that improve patient care while controlling health care costs.

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Published In

Annals of surgery

DOI

EISSN

1528-1140

ISSN

0003-4932

Publication Date

April 2023

Volume

277

Issue

4

Start / End Page

542 / 548

Related Subject Headings

  • Surgery
  • Maryland
  • Length of Stay
  • Humans
  • Health Expenditures
  • Health Care Costs
  • Fee-for-Service Plans
  • Budgets
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Shammas, R. L., Coroneos, C. J., Ortiz-Babilonia, C., Graton, M., Jain, A., & Offodile, A. C. (2023). Implementation of the Maryland Global Budget Revenue Model and Variation in the Expenditures and Outcomes of Surgical Care: A Systematic Review and Meta-analysis. Annals of Surgery, 277(4), 542–548. https://doi.org/10.1097/sla.0000000000005744
Shammas, Ronnie L., Christopher J. Coroneos, Carlos Ortiz-Babilonia, Margaret Graton, Amit Jain, and Anaeze C. Offodile. “Implementation of the Maryland Global Budget Revenue Model and Variation in the Expenditures and Outcomes of Surgical Care: A Systematic Review and Meta-analysis.Annals of Surgery 277, no. 4 (April 2023): 542–48. https://doi.org/10.1097/sla.0000000000005744.
Shammas RL, Coroneos CJ, Ortiz-Babilonia C, Graton M, Jain A, Offodile AC. Implementation of the Maryland Global Budget Revenue Model and Variation in the Expenditures and Outcomes of Surgical Care: A Systematic Review and Meta-analysis. Annals of surgery. 2023 Apr;277(4):542–8.
Shammas, Ronnie L., et al. “Implementation of the Maryland Global Budget Revenue Model and Variation in the Expenditures and Outcomes of Surgical Care: A Systematic Review and Meta-analysis.Annals of Surgery, vol. 277, no. 4, Apr. 2023, pp. 542–48. Epmc, doi:10.1097/sla.0000000000005744.
Shammas RL, Coroneos CJ, Ortiz-Babilonia C, Graton M, Jain A, Offodile AC. Implementation of the Maryland Global Budget Revenue Model and Variation in the Expenditures and Outcomes of Surgical Care: A Systematic Review and Meta-analysis. Annals of surgery. 2023 Apr;277(4):542–548.

Published In

Annals of surgery

DOI

EISSN

1528-1140

ISSN

0003-4932

Publication Date

April 2023

Volume

277

Issue

4

Start / End Page

542 / 548

Related Subject Headings

  • Surgery
  • Maryland
  • Length of Stay
  • Humans
  • Health Expenditures
  • Health Care Costs
  • Fee-for-Service Plans
  • Budgets
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences