Healthcare Resource Utilization in Inguinal Hernia Repair: A Three-Year Cost Evaluation of Truven Health Marketscan Research Databases.

Autor: Rogers AP; Department of Surgery, University of Wisconsin, 600 Highland Avenue MC 7375, Madison, WI 53792. Electronic address: arogers114@gmail.com., Xu Y; Department of Surgery, University of Wisconsin, 600 Highland Avenue MC 7375, Madison, WI 53792., Lidor AO; Department of Surgery, University of Wisconsin, 600 Highland Avenue MC 7375, Madison, WI 53792.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2021 Aug; Vol. 264, pp. 408-417. Date of Electronic Publication: 2021 Apr 10.
DOI: 10.1016/j.jss.2021.02.041
Abstrakt: Background: Inguinal hernia repair is the most commonly performed elective operation in the United States, with over 800,000 cases annually. While clinical outcomes comparing laparoscopic versus open techniques have been well documented, there is little data comparing costs associated with these techniques. This study evaluates the cost of healthcare resources during the 90-d postoperative period following inguinal hernia repair.
Methods: We analyzed data from the Truven Health MarketScan Research Databases. Adult patients with an ICD-9 or CPT code for inguinal hernia repair from 2012 to 2014 were included. Patients with continuous enrollment for 6 mo prior to surgery and 6 mo after surgery were analyzed. Related healthcare service costs (readmission and/or ER visit and/or outpatient visit) were calculated by clinical classification software and generalized linear modeling was used to compare healthcare utilization between groups.
Results: 124,582 cases were identified (open = 84,535; lap = 40,047). Index surgery cost was 41% higher in laparoscopic cases. The cost for readmission was close to $25,000 and similar between both groups, but the laparoscopic group were 12% less likely to be readmitted for surgical complications within 90-d when compared to the open group. Cost of bilateral laparoscopic repair is less than that of serial unilateral open repairs.
Conclusion: Laparoscopic inguinal hernia repair carries a higher index surgery cost than open repair. However, open repair has an increased rate of readmission. To maximize value, efforts should be directed at minimizing readmissions and improving identification of bilateral hernias at the time of initial presentation.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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