T E F Abbott1, A J Fowler2, T D Dobbs3, E M Harrison4, M A Gillies5, R M Pearse1. 1. William Harvey Research Institute, Queen Mary University of London, EC1M 6BQ, UK. 2. Guys and St Thomas' NHS Foundation Trust, SE1 7EH, UK. 3. Welsh Centre for Burns and Plastic Surgery, Abertawe Bro Morgannwg University Health Board, SA6 6NL, UK. 4. Clinical Surgery/Surgical and Perioperative Health Research, University of Edinburgh, EH48 3DF, UK. 5. Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, EH48 3DF, UK.
Abstract
BACKGROUND: Despite evidence of high activity, the number of surgical procedures performed in UK hospitals, their cost and subsequent mortality remain unclear. METHODS: Time-trend ecological study using hospital episode data from England, Scotland, Wales and Northern Ireland. The primary outcome was the number of in-hospital procedures, grouped using three increasingly specific categories of surgery. Secondary outcomes were all-cause mortality, length of hospital stay and healthcare costs according to standard National Health Service tariffs. RESULTS: Between April 1, 2009 and March 31, 2014, 39 631 801 surgical patient episodes were recorded. There was an annual average of 7 926 360 procedures (inclusive category), 5 104 165 procedures (intermediate category) and 1 526 421 procedures (restrictive category). This equates to 12 537, 8073 and 2414 procedures per 100 000 population per year, respectively. On average there were 85 181 deaths (1.1%) within 30 days of a procedure each year, rising to 178 040 deaths (2.3%) after 90 days. Approximately 62.8% of all procedures were day cases. Median length of stay for in-patient procedures was 1.7 (1.3-2.0) days. The total cost of surgery over the 5 yr period was £54.6 billion ($104.4 billion), representing an average annual cost of £10.9 billion (inclusive), £9.5 billion (intermediate) and £5.6 billion (restrictive). For each category, the number of procedures increased each year, while mortality decreased. One-third of all mortalities in national death registers occurred within 90 days of a procedure (inclusive category). CONCLUSIONS: The number of surgical procedures in the UK varies widely according to definition. The number of procedures is slowly increasing whilst the number of deaths is decreasing.
BACKGROUND: Despite evidence of high activity, the number of surgical procedures performed in UK hospitals, their cost and subsequent mortality remain unclear. METHODS: Time-trend ecological study using hospital episode data from England, Scotland, Wales and Northern Ireland. The primary outcome was the number of in-hospital procedures, grouped using three increasingly specific categories of surgery. Secondary outcomes were all-cause mortality, length of hospital stay and healthcare costs according to standard National Health Service tariffs. RESULTS: Between April 1, 2009 and March 31, 2014, 39 631 801 surgical patient episodes were recorded. There was an annual average of 7 926 360 procedures (inclusive category), 5 104 165 procedures (intermediate category) and 1 526 421 procedures (restrictive category). This equates to 12 537, 8073 and 2414 procedures per 100 000 population per year, respectively. On average there were 85 181 deaths (1.1%) within 30 days of a procedure each year, rising to 178 040 deaths (2.3%) after 90 days. Approximately 62.8% of all procedures were day cases. Median length of stay for in-patient procedures was 1.7 (1.3-2.0) days. The total cost of surgery over the 5 yr period was £54.6 billion ($104.4 billion), representing an average annual cost of £10.9 billion (inclusive), £9.5 billion (intermediate) and £5.6 billion (restrictive). For each category, the number of procedures increased each year, while mortality decreased. One-third of all mortalities in national death registers occurred within 90 days of a procedure (inclusive category). CONCLUSIONS: The number of surgical procedures in the UK varies widely according to definition. The number of procedures is slowly increasing whilst the number of deaths is decreasing.
Authors: Silvia Moler-Zapata; Richard Grieve; David Lugo-Palacios; A Hutchings; R Silverwood; Luke Keele; Tommaso Kircheis; David Cromwell; Neil Smart; Robert Hinchliffe; Stephen O'Neill Journal: Med Decis Making Date: 2022-05-24 Impact factor: 2.749
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Authors: Tom E F Abbott; Rupert M Pearse; R Andrew Archbold; Tahania Ahmad; Edyta Niebrzegowska; Andrew Wragg; Reitze N Rodseth; Philip J Devereaux; Gareth L Ackland Journal: Anesth Analg Date: 2018-06 Impact factor: 5.108