John R Handy1, Kelly Denniston, Gary L Grunkemeier, Ying Xing Wu. 1. Providence Cancer Center, Providence Health & Services, Portland, Oregon; Oregon Thoracic & Cardiovascular Surgery, The Oregon Clinic, Portland, Oregon 97213, USA. jhandy@orclinic.com
Abstract
BACKGROUND: No information exists evaluating the costs of complications or death after lobectomy or pneumonectomy. METHODS: We analyzed hospital costs for 294 patients who underwent lobectomy (n=268) or pneumonectomy (n=26) from January 2005 through September 2007. The patients were categorized into two groups on the basis of clinical outcomes: uncomplicated versus complications or death. A cost prediction model was constructed with linear regression using uncomplicated patients only. The model was applied to the complications or death group to predict the expected cost as if they had no complication. The risk-adjusted cost of complications or death was quantified by the difference between the observed cost and the expected cost. RESULTS: There were 241 patients in the uncomplicated group (19 pneumonectomy), and 53 patients had complications or death (7 pneumonectomy). Length of stay was shorter for uncomplicated versus complications or death for both lobectomy and pneumonectomy. Pneumonectomy was costlier than lobectomy. Experiencing complications or death was costlier than costs associated with uncomplicated cases. The actual cost for uncomplicated cases was $18,380. The expected cost for complications or death was similar to that for uncomplicated cases regardless of the number of complications or death. The mean risk-adjusted cost of complications (95% confidence interval) increased by the number of complications: $11,693 ($4,430 to $18,957), $26,673 ($12,320 to $41,025) and $128,450 ($93,971 to $162,930) for 1, 2, and 3 complications, respectively. It was $49,823 ($23,187 to $76,459) for death. CONCLUSIONS: Patients experiencing complications or death have a similar perioperative risk profile as patients without complications. Hospital death or postoperative complications after lobectomy or pneumonectomy are economically costly. Decreasing inpatient death or complications would result in substantial cost-of-care savings.
BACKGROUND: No information exists evaluating the costs of complications or death after lobectomy or pneumonectomy. METHODS: We analyzed hospital costs for 294 patients who underwent lobectomy (n=268) or pneumonectomy (n=26) from January 2005 through September 2007. The patients were categorized into two groups on the basis of clinical outcomes: uncomplicated versus complications or death. A cost prediction model was constructed with linear regression using uncomplicated patients only. The model was applied to the complications or death group to predict the expected cost as if they had no complication. The risk-adjusted cost of complications or death was quantified by the difference between the observed cost and the expected cost. RESULTS: There were 241 patients in the uncomplicated group (19 pneumonectomy), and 53 patients had complications or death (7 pneumonectomy). Length of stay was shorter for uncomplicated versus complications or death for both lobectomy and pneumonectomy. Pneumonectomy was costlier than lobectomy. Experiencing complications or death was costlier than costs associated with uncomplicated cases. The actual cost for uncomplicated cases was $18,380. The expected cost for complications or death was similar to that for uncomplicated cases regardless of the number of complications or death. The mean risk-adjusted cost of complications (95% confidence interval) increased by the number of complications: $11,693 ($4,430 to $18,957), $26,673 ($12,320 to $41,025) and $128,450 ($93,971 to $162,930) for 1, 2, and 3 complications, respectively. It was $49,823 ($23,187 to $76,459) for death. CONCLUSIONS:Patients experiencing complications or death have a similar perioperative risk profile as patients without complications. Hospital death or postoperative complications after lobectomy or pneumonectomy are economically costly. Decreasing inpatient death or complications would result in substantial cost-of-care savings.
Authors: Ira L Leeds; Emmanuel F Drabo; Lisa Soleymani Lehmann; Bashar Safar; Fabian M Johnston Journal: Dis Colon Rectum Date: 2021-06-01 Impact factor: 4.412
Authors: Michelle A T Hildebrandt; Jack A Roth; Ara A Vaporciyan; Xia Pu; Yuanqing Ye; Arlene M Correa; Jae Y Kim; Stephen G Swisher; Xifeng Wu Journal: Sci Rep Date: 2015-07-13 Impact factor: 4.379
Authors: Bruno Barbosa Vieira; Augusto da Cunha Reis; Alan de Paiva Loures; Eliel Carlos Rosa Plácido; Fernanda Ferreira de Sousa Journal: Healthcare (Basel) Date: 2022-08-03