Z Al-Qurayshi1, R Robins2, J Buell1, E Kandil3. 1. Department of Surgery, Tulane University School of Medicine, New Orleans, LA, United States. 2. A.B. Freeman School of Business, Tulane University, New Orleans, LA, United States. 3. Department of Surgery, Tulane University School of Medicine, New Orleans, LA, United States. Electronic address: ekandil@tulane.edu.
Abstract
INTRODUCTION: The number of adrenal surgeries performed in the United Stated is continuing to increase. Identifying factors associated with favorable outcomes can have a major impact on cost-differences. We aim to assess the impact of surgeon volume on both clinical outcomes and cost following adrenal surgery. MATERIALS AND METHODS: A cross-sectional analysis was performed utilizing data from the Nationwide Inpatient Sample, 2003-2009. Surgeon volumes included (adrenalectomies/year): low-volume (1), intermediate-volume (2-6), and high-volume (≥7). RESULTS: A total of 7045 patients were included. Surgeries performed by low-volume surgeons were associated with a higher risk of postoperative complications [OR: 1.66, 95% CI: (1.23, 2.24)]. During the study period, if all operations performed by low-volume surgeons were selectively referred to intermediate-volume surgeons, a 7.7% cost savings would have been incurred. Potential savings were even higher (8.1%) if the operations had been performed by the high-volume surgeons. With the conservative assumption that there are 5000 adrenalectomies per year in the United States, the high-volume surgeons would produce savings of $8.8 million over a span of 14 years. CONCLUSION: A surgeon's expertise is associated with favorable outcomes. Our model estimates that considerable cost savings are attainable with appropriate referrals to high volume endocrine surgeons.
INTRODUCTION: The number of adrenal surgeries performed in the United Stated is continuing to increase. Identifying factors associated with favorable outcomes can have a major impact on cost-differences. We aim to assess the impact of surgeon volume on both clinical outcomes and cost following adrenal surgery. MATERIALS AND METHODS: A cross-sectional analysis was performed utilizing data from the Nationwide Inpatient Sample, 2003-2009. Surgeon volumes included (adrenalectomies/year): low-volume (1), intermediate-volume (2-6), and high-volume (≥7). RESULTS: A total of 7045 patients were included. Surgeries performed by low-volume surgeons were associated with a higher risk of postoperative complications [OR: 1.66, 95% CI: (1.23, 2.24)]. During the study period, if all operations performed by low-volume surgeons were selectively referred to intermediate-volume surgeons, a 7.7% cost savings would have been incurred. Potential savings were even higher (8.1%) if the operations had been performed by the high-volume surgeons. With the conservative assumption that there are 5000 adrenalectomies per year in the United States, the high-volume surgeons would produce savings of $8.8 million over a span of 14 years. CONCLUSION: A surgeon's expertise is associated with favorable outcomes. Our model estimates that considerable cost savings are attainable with appropriate referrals to high volume endocrine surgeons.
Authors: Lorraine I Kelley-Quon; Eveline Shue; Rita V Burke; Caitlin Smith; Karen Kling; Elaa Mahdi; Shadassa Ourshalimian; Michael Fenlon; Matthew Dellinger; Stephen B Shew; Justin Lee; Benjamin Padilla; Thomas Inge; Jonathan Roach; Ahmed I Marwan; Katie W Russell; Romeo Ignacio; Elizabeth Fialkowski; Amar Nijagal; Cecilia Im; Kenneth S Azarow; Daniel J Ostlie; Kasper Wang Journal: Pediatr Surg Int Date: 2021-12-02 Impact factor: 1.827
Authors: Mohammad A Alghafees; Ziyad F Musalli; Khalaf Albaqami; Muhannad Q Alqirnas; Meshari A Alqahtani; Faisal Alrasheed; Ahmed Alasker Journal: Cureus Date: 2022-02-06
Authors: Konstantin L Uttinger; Maria Riedmeier; Joachim Reibetanz; Thomas Meyer; Christoph Thomas Germer; Martin Fassnacht; Armin Wiegering; Verena Wiegering Journal: Front Endocrinol (Lausanne) Date: 2022-07-27 Impact factor: 6.055