The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy
BackgroundUnderstanding the financial implications associated with the complications post-distal pancreatectomy (DP) may be beneficial for the future optimisation of postoperative care pathways and improved cost-efficiency. The primary outcome of this retrospective study was the characterisation of...
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| Format: | Article |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.890518/full |
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| author | Laurence Weinberg Laurence Weinberg Laurence Weinberg Vidhura Ratnasekara Anthony T. Tran Peter Kaldas Tom Neal-Williams Michael R. D’Silva Jackson Hua Sean Yip Patryck Lloyd-Donald Luke Fletcher Luke Fletcher Ronald Ma Marcos V. Perini Mehrdad Nikfarjam Dong-Kyu Lee |
| author_facet | Laurence Weinberg Laurence Weinberg Laurence Weinberg Vidhura Ratnasekara Anthony T. Tran Peter Kaldas Tom Neal-Williams Michael R. D’Silva Jackson Hua Sean Yip Patryck Lloyd-Donald Luke Fletcher Luke Fletcher Ronald Ma Marcos V. Perini Mehrdad Nikfarjam Dong-Kyu Lee |
| author_sort | Laurence Weinberg |
| collection | DOAJ |
| description | BackgroundUnderstanding the financial implications associated with the complications post-distal pancreatectomy (DP) may be beneficial for the future optimisation of postoperative care pathways and improved cost-efficiency. The primary outcome of this retrospective study was the characterisation of the additional cost associated with postoperative complications following DP. The secondary outcome was the estimation of the prevalence, type and severity of complications post-DP and the determination of which complications were associated with higher costs.MethodsPostoperative complications were retrospectively examined for 62 adult patients undergoing distal pancreatectomy at an Australian university hospital between January 2012 and July 2021. Complications were defined and graded using the Clavien–Dindo (CVD) classification system. In-hospital cost of index admission was calculated using an activity-based costing methodology and was reported in US dollars at 2021 rates. Regression modelling was used to investigate the relationships among selected perioperative variables, complications and costs.Results45 patients (72.6%) experienced one or more postoperative complications. The median (IQR) hospital cost in US dollars was 31.6% greater in patients who experienced complications compared to those who experienced no complications ($40,717.8 [27,358.0–59,834.3] vs. $30,946.9 [23,910.8–46,828.1]). Costs for patients with four or more complications were 43.5% higher than for those with three or fewer complications (p = 0.015). Compared to patients with no complications, the median hospital costs increased by 17.1% in patients with minor complications (CVD grade I/II) and by 252% in patients who developed major complication (i.e., CVD grade III/IV) complications.ConclusionPostoperative complications are a key target for cost-containment strategies. Our findings demonstrate a high prevalence of postoperative complications following distal pancreatectomy with number and severity of postoperative complications being associated with increased hospital costs. (Registered in the Australian New Zealand Clinical Trials Registry [No. ACTRN12622000202763]). |
| first_indexed | 2024-12-12T04:45:19Z |
| format | Article |
| id | doaj.art-fc1841cf57634b6b840f6d4022f711e3 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-12T04:45:19Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-fc1841cf57634b6b840f6d4022f711e32022-12-22T00:37:40ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-05-01910.3389/fsurg.2022.890518890518The Association of Postoperative Complications and Hospital Costs Following Distal PancreatectomyLaurence Weinberg0Laurence Weinberg1Laurence Weinberg2Vidhura Ratnasekara3Anthony T. Tran4Peter Kaldas5Tom Neal-Williams6Michael R. D’Silva7Jackson Hua8Sean Yip9Patryck Lloyd-Donald10Luke Fletcher11Luke Fletcher12Ronald Ma13Marcos V. Perini14Mehrdad Nikfarjam15Dong-Kyu Lee16Department of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Critical Care, The University of Melbourne, Austin Health, Heidelberg, AustraliaDepartment of Surgery, The University of Melbourne, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Surgery, The University of Melbourne, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaDepartment of Anaesthesia, Austin Health, Heidelberg, AustraliaData Analytics Research and Evaluation (DARE) Centre, Austin Health, Heidelberg, AustraliaBusiness Intelligence Unit, Austin Health, Heidelberg, AustraliaDepartment of Surgery, The University of Melbourne, Austin Health, Heidelberg, AustraliaDepartment of Surgery, The University of Melbourne, Austin Health, Heidelberg, AustraliaDepartment of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of KoreaBackgroundUnderstanding the financial implications associated with the complications post-distal pancreatectomy (DP) may be beneficial for the future optimisation of postoperative care pathways and improved cost-efficiency. The primary outcome of this retrospective study was the characterisation of the additional cost associated with postoperative complications following DP. The secondary outcome was the estimation of the prevalence, type and severity of complications post-DP and the determination of which complications were associated with higher costs.MethodsPostoperative complications were retrospectively examined for 62 adult patients undergoing distal pancreatectomy at an Australian university hospital between January 2012 and July 2021. Complications were defined and graded using the Clavien–Dindo (CVD) classification system. In-hospital cost of index admission was calculated using an activity-based costing methodology and was reported in US dollars at 2021 rates. Regression modelling was used to investigate the relationships among selected perioperative variables, complications and costs.Results45 patients (72.6%) experienced one or more postoperative complications. The median (IQR) hospital cost in US dollars was 31.6% greater in patients who experienced complications compared to those who experienced no complications ($40,717.8 [27,358.0–59,834.3] vs. $30,946.9 [23,910.8–46,828.1]). Costs for patients with four or more complications were 43.5% higher than for those with three or fewer complications (p = 0.015). Compared to patients with no complications, the median hospital costs increased by 17.1% in patients with minor complications (CVD grade I/II) and by 252% in patients who developed major complication (i.e., CVD grade III/IV) complications.ConclusionPostoperative complications are a key target for cost-containment strategies. Our findings demonstrate a high prevalence of postoperative complications following distal pancreatectomy with number and severity of postoperative complications being associated with increased hospital costs. (Registered in the Australian New Zealand Clinical Trials Registry [No. ACTRN12622000202763]).https://www.frontiersin.org/articles/10.3389/fsurg.2022.890518/fulldistal pancreatectomy (DP)distal pancreatectomy and splenectomycomplicationscostsanaesthesiasurgery |
| spellingShingle | Laurence Weinberg Laurence Weinberg Laurence Weinberg Vidhura Ratnasekara Anthony T. Tran Peter Kaldas Tom Neal-Williams Michael R. D’Silva Jackson Hua Sean Yip Patryck Lloyd-Donald Luke Fletcher Luke Fletcher Ronald Ma Marcos V. Perini Mehrdad Nikfarjam Dong-Kyu Lee The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy Frontiers in Surgery distal pancreatectomy (DP) distal pancreatectomy and splenectomy complications costs anaesthesia surgery |
| title | The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy |
| title_full | The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy |
| title_fullStr | The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy |
| title_full_unstemmed | The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy |
| title_short | The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy |
| title_sort | association of postoperative complications and hospital costs following distal pancreatectomy |
| topic | distal pancreatectomy (DP) distal pancreatectomy and splenectomy complications costs anaesthesia surgery |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.890518/full |
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