Does healthcare system device volume correlate with price paid for spinal implants: a cross-sectional analysis of a national purchasing database

Autor: Eli Cahan, Kelly McFarlane, Nicole Segovia, Amanda Chawla, James Wall, Kevin Shea
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMJ Open, Vol 12, Iss 4 (2022)
Druh dokumentu: article
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2021-057547
Popis: Objectives Amid continuously rising US healthcare costs, particularly for inpatient and surgical services, strategies to more effectively manage supply chain expenses are urgently necessary. Across industries, the ‘economy of scale’ principle indicates that larger purchasing volumes should correspond to lower prices due to ‘bulk discounts’. Even as such advantages of scale have driven health system mergers in the USA, it is not clear whether they are being achieved, including for specialised products like surgical implants which may be more vulnerable to cost inefficiency. The objective of this observational cross-sectional study was to investigate whether purchasing volumes for spinal implants was correlated with price paid.Setting USA.Participants Market data based on pricing levels for spine implants were reviewed from industry implant price databases. Filters were applied to narrow the sample to include comparable institutions based on procedural volume, patient characteristics and geographical considerations. Information on the attributes of 619 health systems representing 12 471 provider locations was derived from national databases and analytics platforms.Primary outcome measure Institution-specific price index paid for spinal implants, normalised to the national average price point achieved.Results A Spearman’s correlation test indicated a weak relationship between purchasing volume and price index paid (ρ=−0.35, p
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