Alvimopan Use, Outcomes, and Costs: A Report from the Surgical Care and Outcomes Assessment Program-Comparative Effectiveness Research Translation Network Collaborative
| Autor: | Alessandro Fichera, Raman Menon, Vlad V. Simianu, Amir L. Bastawrous, Michael G. Florence, Giana H. Davidson, Richard C. Thirlby, Richard P. Billingham, Anne P. Ehlers, Farhood Farjah, David R. Flum |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal agent business.industry 030503 health policy & services medicine.medical_treatment Comparative effectiveness research Retrospective cohort study Colorectal surgery Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Alvimopan Surgery 030212 general & internal medicine 0305 other medical science Intensive care medicine business Elective Surgical Procedure Colectomy medicine.drug |
| Popis: | Background Randomized trials have found that alvimopan hastens return of bowel function and reduces length of stay (LOS) by 1 day among patients undergoing colorectal surgery. However, its effectiveness in routine clinical practice and its impact on hospital costs remain uncertain. Study Design We performed a retrospective cohort study of patients undergoing elective colorectal surgery in Washington state (2009 to 2013) using data from a clinical registry (Surgical Care and Outcomes Assessment Program) linked to a statewide hospital discharge database (Comprehensive Hospital Abstract Reporting System). We used generalized estimating equations to evaluate the relationship between alvimopan and outcomes, and adjusted for patient, operative, and management characteristics. Hospital charges were converted to costs using hospital-specific charge to cost ratios, and were adjusted for inflation to 2013 US dollars. Results Among 14,781 patients undergoing elective colorectal surgery at 51 hospitals, 1,615 (11%) received alvimopan. Patients who received alvimopan had a LOS that was 1.8 days shorter (p Conclusions When used in routine clinical practice, alvimopan was associated with a shorter LOS and limited but significant hospital cost savings. Both efficacy and effectiveness data support the use of alvimopan in routine clinical practice, and its use could be measured as a marker of higher quality care. |
| Databáze: | OpenAIRE |
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