The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them?
AIM: Our aim was to determine the frequency and economic impact of anastomotic leakage (AL) at local and national levels in England. METHOD: All patients who underwent AR in Oxford between 2007 and 2009 were evaluated for AL. Hospital Episode Statistics (HES) data were used to determine reoperation...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2013
|
| _version_ | 1797065492053098496 |
|---|---|
| author | Ashraf, S Burns, E Jani, A Altman, S Young, J Cunningham, C Faiz, O Mortensen, N |
| author_facet | Ashraf, S Burns, E Jani, A Altman, S Young, J Cunningham, C Faiz, O Mortensen, N |
| author_sort | Ashraf, S |
| collection | OXFORD |
| description | AIM: Our aim was to determine the frequency and economic impact of anastomotic leakage (AL) at local and national levels in England. METHOD: All patients who underwent AR in Oxford between 2007 and 2009 were evaluated for AL. Hospital Episode Statistics (HES) data were used to determine reoperation rates after elective AR (n = 23 388) in England between 2000 and 2008. Hospital episode remuneration costs were calculated by the local commissioning department and compared with Department of Health (DH) reference index costs. RESULTS: The frequency of AL following anterior resection was 10.9% (31 out of 285) in Oxford. Laparotomy for leakage was performed in 5.6% of cases. The 30-day hospital mortality rate for all ARs was 2.1%, compared with 3.2% after AL. The national relaparotomy rate (within 28 days) and 30-day hospital mortality in English National Health Service (NHS) trusts following AR were 5.9% and 2.9%, respectively. Institutional remunerated tariffs (£6233 (SD ± 965)) were similar to DH reference costs (£6319 (SD ± 1830)) after uncomplicated AR. However, there was a significant (P = 0.008) discrepancy between the remunerated tariff for AL (£9605 (SD ± 6908)) and the actual cost (£17 220 (SD ± 9642)). AL resulted in an additional annual cost of approximately £1.1 million to £3.5 million when extrapolated nationally. CONCLUSION: The estimated economic burden of anastomotic leakage following AR is approximately double that of the remunerated tariff. |
| first_indexed | 2024-03-06T21:29:22Z |
| format | Journal article |
| id | oxford-uuid:44251415-27b8-4a65-988b-80a2c7888616 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:29:22Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:44251415-27b8-4a65-988b-80a2c78886162022-03-26T14:59:49ZThe economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:44251415-27b8-4a65-988b-80a2c7888616EnglishSymplectic Elements at Oxford2013Ashraf, SBurns, EJani, AAltman, SYoung, JCunningham, CFaiz, OMortensen, N AIM: Our aim was to determine the frequency and economic impact of anastomotic leakage (AL) at local and national levels in England. METHOD: All patients who underwent AR in Oxford between 2007 and 2009 were evaluated for AL. Hospital Episode Statistics (HES) data were used to determine reoperation rates after elective AR (n = 23 388) in England between 2000 and 2008. Hospital episode remuneration costs were calculated by the local commissioning department and compared with Department of Health (DH) reference index costs. RESULTS: The frequency of AL following anterior resection was 10.9% (31 out of 285) in Oxford. Laparotomy for leakage was performed in 5.6% of cases. The 30-day hospital mortality rate for all ARs was 2.1%, compared with 3.2% after AL. The national relaparotomy rate (within 28 days) and 30-day hospital mortality in English National Health Service (NHS) trusts following AR were 5.9% and 2.9%, respectively. Institutional remunerated tariffs (£6233 (SD ± 965)) were similar to DH reference costs (£6319 (SD ± 1830)) after uncomplicated AR. However, there was a significant (P = 0.008) discrepancy between the remunerated tariff for AL (£9605 (SD ± 6908)) and the actual cost (£17 220 (SD ± 9642)). AL resulted in an additional annual cost of approximately £1.1 million to £3.5 million when extrapolated nationally. CONCLUSION: The estimated economic burden of anastomotic leakage following AR is approximately double that of the remunerated tariff. |
| spellingShingle | Ashraf, S Burns, E Jani, A Altman, S Young, J Cunningham, C Faiz, O Mortensen, N The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them? |
| title | The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them? |
| title_full | The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them? |
| title_fullStr | The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them? |
| title_full_unstemmed | The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them? |
| title_short | The economic impact of anastomotic leakage after anterior resections in English NHS hospitals: are we adequately remunerating them? |
| title_sort | economic impact of anastomotic leakage after anterior resections in english nhs hospitals are we adequately remunerating them |
| work_keys_str_mv | AT ashrafs theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT burnse theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT jania theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT altmans theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT youngj theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT cunninghamc theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT faizo theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT mortensenn theeconomicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT ashrafs economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT burnse economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT jania economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT altmans economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT youngj economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT cunninghamc economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT faizo economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem AT mortensenn economicimpactofanastomoticleakageafteranteriorresectionsinenglishnhshospitalsareweadequatelyremuneratingthem |