title: [Better care and lower costs through registries; a first step to reimbursement based on outcome].
abstract: We have recently shown that costs of surgical treatment for colorectal carcinoma differ greatly between various patient groups in the Netherlands. Those cost-differences could mostly be explained by the fact that high-risk patients have a greater risk of complications, which generate higher hospital costs. Hospitals with a high-risk population, for instant tertiary referral centres, spend more than hospitals that treat low-risk patients. Currently reimbursement however is not geared to risk differences. In this article we investigate this shortcoming of the current reimbursement system and discuss how a differential rewarding - in which reimbursement is aligned with the patient's risk profile - could serve as a tool to further quality improvement in healthcare. Current clinical registries may provide the necessary details of patient characteristics for risk profiling and may also contribute to the following goal: reimbursement based on the quality of delivered care.
authors.affiliation: LUMC, afd. Heelkunde, Leiden.
authors.forename: J A
authors.initials: JA
authors.lastname: Goveart
authors.forename: W A
authors.initials: WA
authors.lastname: van Dijk
authors.forename: M W J M
authors.initials: MW
authors.lastname: Wouters
mesh_terms: D015179:Colorectal Neoplasms / Q000191:economics* / Q000628:therapy*; D003695:Delivery of Health Care / Q000592:standards*; D005102:Health Expenditures; D017721:Hospital Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D058996:Quality Improvement; D012042:Registries; D062606:Tertiary Care Centers