Economic burden of cancer among patients with surgical resections of the lung, rectum, liver and uterus: results from a US hospital database claims analysisReportar como inadecuado




Economic burden of cancer among patients with surgical resections of the lung, rectum, liver and uterus: results from a US hospital database claims analysis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Health Economics Review

, 7:22

First Online: 02 June 2017Received: 03 February 2017Accepted: 18 May 2017DOI: 10.1186-s13561-017-0160-8

Cite this article as: Kalsekar, I., Hsiao, CW., Cheng, H. et al. Health Econ Rev 2017 7: 22. doi:10.1186-s13561-017-0160-8

Abstract

ObjectivesTo determine hospital resource utilization, associated costs and the risk of complications during hospitalization for four types of surgical resections and to estimate the incremental burden among patients with cancer compared to those without cancer.

MethodsPatients ≥18 years old were identified from the Premier Research Database of US hospitals if they had any of the following types of elective surgical resections between 1-2008 and 12-2014: lung lobectomy, lower anterior resection of the rectum LAR, liver wedge resection, or total hysterectomy. Cancer status was determined based on ICD-9-CM diagnosis codes. Operating room time ORT, length of stay LOS, and total hospital costs, as well as frequency of bleeding and infections during hospitalization were evaluated. The impact of cancer status on outcomes from a hospital perspective was evaluated using multivariable generalized estimating equation models; analyses were conducted separately for each resection type.

ResultsAmong the identified patients who underwent surgical resection, 23 858 87.9% with cancer underwent lung lobectomy, 13 522 63.8% with cancer underwent LAR, 2916 30.0% with cancer underwent liver wedge resection and 225 075 11.3% with cancer underwent total hysterectomy. After adjusting for patient, procedural, and hospital characteristics, mean ORT, LOS, and hospital cost were statistically higher by 3.2%, 8.2%, and 9.2%, respectively for patients with cancer vs. no cancer who underwent lung lobectomy; statistically higher by 6.9%, 9.4%, and 9.6%, respectively for patients with cancer vs. no cancer who underwent LAR; statistically higher by 4.9%, 14.8%, and 15.7%, respectively for patients with cancer vs. no cancer who underwent liver wedge resection; and statistically higher by 16.0%, 27.4%, and 31.3%, respectively for patients with cancer vs. no cancer who underwent total hysterectomy. Among patients who underwent each type of resection, risks for bleeding and infection were generally higher among patients with cancer as compared to those without cancer.

ConclusionsIn this analysis, we found that patients who underwent lung lobectomy, lower anterior resection of the rectum LAR, liver wedge resection or total hysterectomy for a cancer indication have significantly increased hospital resource utilization compared to these same surgeries for benign indications.

KeywordsSurgical organ resections Healthcare costs Economic burden, Cancer surgery 



Autor: Iftekhar Kalsekar - Chia-Wen Hsiao - Hang Cheng - Sashi Yadalam - Brian Po-Han Chen - Laura Goldstein - Andrew Yoo

Fuente: https://link.springer.com/







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