Retrospective Analysis of Never Events in Panniculectomy and Abdominoplasty Patients and Their Financial Implications

Abstract

In 2008, the Centers for Medicare and Medicaid Services adapted a list from the National Quality Forum consisting of ten hospital-acquired conditions (HAC), also known as never events. Deeming such events as preventable in a safe hospital setting, reimbursement is no longer provided for treatments arising secondary to these events. A retrospective chart review identified 90 panniculectomy and abdominoplasty patients. The HAC examined include surgical site infections (SSI), vascular catheter-associated infections, deep venous thrombosis/pulmonary embolism, retained foreign body, catheter-related urinary tract infection, manifestations of poor glycemic control, falls and trauma, air embolism, pressure ulcers (stages III and IV), and blood incompatibility. Information regarding age, American Society of Anesthesiologists (ASA) Classification, body mass index, smoking, and chemotherapy were collected. Patients were divided into two groups: those that developed never events and those with no events. Of the 90 patients, 14 (15.5 %) developed never events as a result of SSI. No events occurred in the remaining nine categories. Statistically significant risk factors included ASA, age, and diabetes mellitus. The most common never event was SSI. In light of the obvious prevalence of the risk factors in patients who develop these events, the question of whether or not never events are truly unavoidable arises. Despite this, awareness of the impact on patient care, health care, and hospital reimbursement is vital in understanding the new paradigm of the “one size fits all.”

Allen Gabriel, MD, FACS, is a consultant for Allergan and Acelity.

The manuscript and figures were reprinted with permission from Wolters Kluwer Health, by Champaneria et al., Retrospective Analysis of Never Events in Panniculectomy and Abdominoplasty Patients and Their Financial Implications, Ann Plastic Surg. 2014;73:412–5.