Predictors of 'Never-Event' Complications Identified

Authors say policy of denying payment for many never events is often counterproductive
By Rick Ansorge
HealthDay Reporter

WEDNESDAY, Feb. 17 (HealthDay News) -- After major surgery, the occurrence of complications designated as "never events" by the Centers for Medicare and Medicaid Services is affected by patient and disease characteristics and by the type of operation performed, according to a study in the February issue of the Archives of Surgery.

Donald E. Fry, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues analyzed the effect of recognizable external factors on the occurrence of eight infection-related complications designated as never events.

The researchers found that patient characteristics and procedural interventions were significant predictors of six of the eight never-event complications. They also found that the discriminatory power of predictive equations for all eight never-event complications significantly increased after the inclusion of hospital variables.

"Our findings suggest that the Centers for Medicare and Medicaid Services' policy of denying payment for a wide variety of never events will be counterproductive in many cases because most hospital acquired complications cannot be eliminated entirely by adherence to current best practices," the authors write. "To recognize this fact, payment to cover the cost of caring for potentially avoidable complications should be based on empirically derived rates and costs of complications for providers who deliver documented high-quality care."

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