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Health economic implications of complications associated with pancreaticoduodenectomy at a University Hospital: a retrospective cohort cost study

Published on Dec 1, 2017in Hpb 3.05
· DOI :10.1016/j.hpb.2017.11.001
Jason Wang1
Estimated H-index: 1
(University of Melbourne),
Ronald Ma1
Estimated H-index: 1
+ 6 AuthorsLaurence Weinberg15
Estimated H-index: 15
(University of Melbourne)
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Abstract
Abstract Background A cost analyses of complications following pancreaticoduodenectomy (PD) was performed in a high volume hepato-biliary-pancreatic service. We hypothesised that costs are increased with both severity and number of complications; we investigated the relationship between complications and specific cost centres. Methods 100 patients from 2011 to 2016 were included. Data relating to their perioperative course were collected. Complications were documented by the Clavien–Dindo classification and costs were inflated and converted to 2017 USD. Results Mean hospital costs in complicated patients more than doubled those of uncomplicated patients (28 330 vs. 7 150, p Conclusion The development of complications following PD is common, costly and associated with increased length of stay. Costs increased with greater complication severity, and specific complications. The in-depth breakdown of hospital costs suggests specific targets for cost containment.
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Published on Sep 1, 2017in Anaesthesia and Intensive Care 1.36
Laurence Weinberg15
Estimated H-index: 15
(University of Melbourne),
Jonathan Banting2
Estimated H-index: 2
(University of Melbourne)
+ 9 AuthorsVijayaragavan Muralidharan21
Estimated H-index: 21
(University of Melbourne)
Published on Oct 12, 2016in Cochrane Database of Systematic Reviews 7.75
Paul A. Carless13
Estimated H-index: 13
(University of Newcastle),
David Henry MBChB53
Estimated H-index: 53
+ 3 AuthorsKatharine Ker21
Estimated H-index: 21
(Lond: University of London)
Background There is considerable uncertainty regarding the optimal haemoglobin threshold for the use of red blood cell (RBC) transfusions in anaemic patients. Blood is a scarce resource, and in some countries, transfusions are less safe than others because of a lack of testing for viral pathogens. Therefore, reducing the number and volume of transfusions would benefit patients. Objectives The aim of this review was to compare 30-day mortality and other clinical outcomes in participants randomize...
Published on Sep 1, 2015in Journal of Gastrointestinal Surgery 2.69
Joshua D. Eisenberg1
Estimated H-index: 1
(Thomas Jefferson University),
Ernest L. Rosato24
Estimated H-index: 24
(Thomas Jefferson University)
+ 2 AuthorsJordan M. Winter34
Estimated H-index: 34
(Thomas Jefferson University)
Introduction Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy (PD), yet it remains incompletely understood. The International Study Group of Pancreatic Surgery (ISGPS) in 2007 defined a three-tiered grading system to standardize studies of DGE.
Published on Aug 1, 2015in Hpb 3.05
Trientje B. Santema5
Estimated H-index: 5
,
Annelies Visser5
Estimated H-index: 5
+ 4 AuthorsDirk T. Ubbink40
Estimated H-index: 40
Background A pancreatoduodenectomy (PD) is a highly advanced procedure associated with considerable post-operative complications and substantial costs. In this study the hospital costs associated with complications after PD were assessed.
Published on Aug 1, 2015in Annals of Surgery 9.48
William Knechtle5
Estimated H-index: 5
,
Sebastian D. Perez17
Estimated H-index: 17
+ 10 AuthorsVirginia Oliva Shaffer9
Estimated H-index: 9
Objective: To determine the relationship between complications after 3 common general surgery procedures and per-episode hospital finances. Background: With impending changes in health care reimbursement, maximizing the value of care delivered is paramount. Data on the relative clinical and financial impact of postoperative complications are necessary for directing surgical quality improvement efforts. Methods: We reviewed the medical records of patients enrolled in the American College of Surge...
Published on Jul 1, 2014in JAMA Surgery 10.67
Erin G. Brown9
Estimated H-index: 9
(UC Davis: University of California, Davis),
Anthony D. Yang17
Estimated H-index: 17
(UC Davis: University of California, Davis)
+ 1 AuthorsRichard J. Bold30
Estimated H-index: 30
(UC Davis: University of California, Davis)
Importance Changes in health care reimbursement policy have led to an era in which hospitals are motivated to improve quality of care while simultaneously reducing costs. Research demonstrating the most efficient means to target costs may have a positive effect on patient quality of life and the overburdened health care system. Objective To evaluate the effect of hospital length of stay (LOS) and the occurrence of postoperative complications on total charges in patients undergoing elective pancr...
Published on Apr 1, 2014in Journal of Gastrointestinal Surgery 2.69
Laura M. Enomoto8
Estimated H-index: 8
(Penn State Milton S. Hershey Medical Center),
Niraj J. Gusani18
Estimated H-index: 18
(Penn State Milton S. Hershey Medical Center)
+ 1 AuthorsChristopher S. Hollenbeak38
Estimated H-index: 38
(Penn State Milton S. Hershey Medical Center)
Background Improved mortality rates following pancreaticoduodenectomy by high-volume surgeons and hospitals have been well documented, but less is known about the impact of such volumes on length of stay and cost. This study uses data from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) to examine the effect of surgeon and hospital volume on mortality, length of stay, and cost following pancreaticoduodenectomy while controlling for patient-specific factors.
Published on Apr 1, 2014in British Journal of Surgery 5.59
R. Yoshioka1
Estimated H-index: 1
(UTokyo: University of Tokyo),
Hideo Yasunaga31
Estimated H-index: 31
(UTokyo: University of Tokyo)
+ 6 AuthorsN. Kokudo65
Estimated H-index: 65
(UTokyo: University of Tokyo)
Background High morbidity and mortality rates after pancreaticoduodenectomy (PD) have led to concentration of this surgery in high-volume centres, with improved outcomes. The extent to which better outcomes might be apparent in a healthcare system where the mortality rate is already low is unclear. Methods The Japanese Diagnosis Procedure Combination database was used to identify patients undergoing PD between 2007 and 2010. Patient data included age, sex, co-morbidities at admission, type of ho...
Ajay S. Patel1
Estimated H-index: 1
,
Annika Bergman3
Estimated H-index: 3
(Takeda Pharmaceutical Company)
+ 1 AuthorsUlf Haglund24
Estimated H-index: 24
(Uppsala University)
Objectives On the basis of a systematic review, we aimed to establish the cost and drivers of cost and/or resource use of intra- and perioperative complications occurring as a result of selected major surgical procedures, as well as to understand the relationship between costs and severity of complication and, consequently, the economic burden they represent. We also assessed the clinical and economic methodologies used to derive costs and resource use across the studies with a view to providing...
Published on Jan 1, 2013in Surgery 3.48
Tara S. Kent19
Estimated H-index: 19
(BIDMC: Beth Israel Deaconess Medical Center),
Teviah Sachs13
Estimated H-index: 13
(BIDMC: Beth Israel Deaconess Medical Center)
+ 1 AuthorsCharles M. Vollmer38
Estimated H-index: 38
(BIDMC: Beth Israel Deaconess Medical Center)
Background Infection control is potentially a critical quality indicator but remains incompletely understood, especially in high-acuity gastrointestinal surgery. Our objective was to evaluate the incidence and impact of infections after elective pancreatectomy at the practice level. Methods All pancreatectomies performed by three pancreatic surgical specialists over an 8-year period (2001–2009) followed standardized perioperative care, including timely antibiotic administration. Infections were ...