Health economic implications of complications associated with pancreaticoduodenectomy at a University Hospital: a retrospective cohort cost study
| Autor: | Laurence Weinberg, David Debono, Christopher Christophi, Ray Robbins, Mehrdad Nikfarjam, Jason Wang, Ronald Cw Ma, Paul Eleftheriou, Leonid Churilov |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment MEDLINE 030230 surgery Severity of Illness Index Pancreaticoduodenectomy Hospitals University 03 medical and health sciences Patient safety Postoperative Complications 0302 clinical medicine Severity of illness medicine Humans Hospital Costs health care economics and organizations Aged Retrospective Studies Hepatology business.industry Gastroenterology Retrospective cohort study Perioperative Length of Stay Middle Aged Models Economic Treatment Outcome Clinical research 030220 oncology & carcinogenesis Emergency medicine Female Complication business Hospitals High-Volume |
| Zdroj: | HPB. 20:423-431 |
| ISSN: | 1365-182X |
| Popis: | 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.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.Mean hospital costs in complicated patients more than doubled those of uncomplicated patients ($28 330 vs. $57 150, p0.0001). Total hospital costs significantly increased with both severity and number of complications. This cost increase was influenced by medical consult, pathology, pharmacy, radiology, ward, intensive care, and allied health costs, but not operating theatre or anaesthesia costs. Postoperative pancreatic fistula, postoperative haemorrhage, delayed gastric emptying and infection were associated with cost differentials of $65 438, $74 079, $35 620 and $46 316 respectively over uncomplicated patients.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. |
| Databáze: | OpenAIRE |
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