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Cost burden following esophagectomy: A single centre observational study.
Buchholz, Vered; Lee, Dong Kyu; Liu, David S; Aly, Ahmad; Barnett, Stephen A; Hazard, Riley; Le, Peter; Kioussis, Benjamin; Muralidharan, Vijayaragavan; Weinberg, Laurence.
Afiliación
  • Buchholz V; Department of Surgery, Austin Health, Melbourne 3084, Victoria, Australia.
  • Lee DK; Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Seoul 14566, Goyang, South Korea.
  • Liu DS; Department of Surgery, Austin Health, The University of Melbourne, Melbourne 3084, Victoria, Australia.
  • Aly A; Department of Surgery, Austin Health, The University of Melbourne, Melbourne 3084, Victoria, Australia.
  • Barnett SA; Department of Surgery, Austin Health, The University of Melbourne, Melbourne 3084, Victoria, Australia.
  • Hazard R; Department of Anesthesia, Austin Health, Melbourne 3084, Victoria, Australia.
  • Le P; Department of Anesthesia, Austin Health, Melbourne 3084, Victoria, Australia.
  • Kioussis B; Department of Anesthesia, Austin Health, Melbourne 3084, Victoria, Australia.
  • Muralidharan V; Department of Surgery, Austin Health, The University of Melbourne, Melbourne 3084, Victoria, Australia.
  • Weinberg L; Department of Anesthesia, Austin Hospital, Heidelberg 3084, Victoria, Australia.
World J Gastrointest Surg ; 16(7): 2255-2269, 2024 Jul 27.
Article en En | MEDLINE | ID: mdl-39087114
ABSTRACT

BACKGROUND:

Cost analyses of patients undergoing esophagectomy is valuable for identifying modifiable expenditure drivers to target and curtail costs while improving the quality of care. We aimed to define the cost-complication relationship after esophagectomy and delineate the incremental contributions to costs.

AIM:

To assess the relationship between the hospital costs and potential cost drivers post esophagectomy and investigate the relationship between the cost-driving variables (predicting variables) and hospital costs (dependent variable).

METHODS:

In this retrospective single center study, the severity of complications was graded using the Clavien-Dindo (CD) classification system. Key esophagectomy complications were categorized and defined according to consensus guidelines. Raw costing data included the in-hospital costs of the index admission and any unplanned admission within 30 postoperative days. We used correlation analysis to assess the relationship between key clinical variables and hospital costs (in United States dollars) to identify cost drivers. A mediation model was used to investigate the relationship between these variables and hospital costs.

RESULTS:

A total of 110 patients underwent primary esophageal resection. The median admission cost was $47822.7 (interquartile range 35670.2-68214.0). The total effects on costs were $13593.9 (95%CI 10187.1-17000.8, P < 0.001) for each increase in CD severity grade, $4781 (95%CI 3772.7-5789.3, P < 0.001) for each increase in the number of complications, and $42552.2 (95%CI 8309-76795.4, P = 0.015) if a key esophagectomy complication developed. Key esophagectomy complications drove the costs directly by $11415.7 (95%CI 992.5-21838.9, P = 0.032).

CONCLUSION:

The severity and number of complications, and the development of key esophagectomy complications significantly contributed to total hospital costs. Continuous institutional initiatives and strategies are needed to enhance patient outcomes and minimize costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World J Gastrointest Surg Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World J Gastrointest Surg Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos