Juan-Carlos Gomez-Rosado1, Jose Salas-Turrens2, Antonio Olry-de-Labry-Lima3. 1. UGC Cirugía General y Digestiva, Hospital Universitario Virgen Macarena, Sevilla, España; Departamento de Cirugía, Universidad de Sevilla, Sevilla, España. Electronic address: dr.gomez.rosado@gmail.com. 2. Unidad de Documentación Clínica, Hospital Universitario Virgen Macarena, Sevilla, España. 3. Escuela Andaluza de Salud Pública, Granada, España.
Abstract
INTRODUCTION: The aim was to assess the impact on economic costs and length of stay (LOS) of postoperative complications. METHODS: 5,822 records from BMDS (2014-2015) are included. A descriptive, univariate and multivariate study evaluated the correlation between complications, Clavien-Dindo grade and vacation periods with LOS and economic costs, based on a full-cost model, aggregated by DRG. RESULTS AND CONCLUSIONS: Mean cost per stay was €676.71, and €4,309.02 per episode. Complications appeared in 639 patients (11%). Admission to ICU was required in 203 patients, re-operation in 134 and re-admission in 243, while 66 patients died (1.1%). Complications caused significantly longer LOS (20.08 vs 5.48 days) and higher economic cost (€11,670.31 vs €3,354.12); infectious complications were the most frequent and respiratory the most expensive (€20,428.53), together with ICU admission (€20,242.66). Clavien-Dindo grade correlated with greater LOS and costs (except gradev). During vacation periods, complications and LOS are increased, but costs of these complications and LOS did not differ significantly from complications detected in non-vacation periods.
INTRODUCTION: The aim was to assess the impact on economic costs and length of stay (LOS) of postoperative complications. METHODS: 5,822 records from BMDS (2014-2015) are included. A descriptive, univariate and multivariate study evaluated the correlation between complications, Clavien-Dindo grade and vacation periods with LOS and economic costs, based on a full-cost model, aggregated by DRG. RESULTS AND CONCLUSIONS: Mean cost per stay was €676.71, and €4,309.02 per episode. Complications appeared in 639 patients (11%). Admission to ICU was required in 203 patients, re-operation in 134 and re-admission in 243, while 66 patients died (1.1%). Complications caused significantly longer LOS (20.08 vs 5.48 days) and higher economic cost (€11,670.31 vs €3,354.12); infectious complications were the most frequent and respiratory the most expensive (€20,428.53), together with ICU admission (€20,242.66). Clavien-Dindo grade correlated with greater LOS and costs (except gradev). During vacation periods, complications and LOS are increased, but costs of these complications and LOS did not differ significantly from complications detected in non-vacation periods.
Keywords:
Cirugía general; Complicaciones postoperatorias; Costos y análisis de costo; Costs and cost-analysis; General surgery; Hospitales públicos; Postoperative complications; Public hospital
Authors: Sejal Patel; Maroeska M Rovers; Michiel J P Sedelaar; Petra L M Zusterzeel; Ad F T M Verhagen; Camiel Rosman; Janneke P C Grutters Journal: BMJ Surg Interv Health Technol Date: 2021-02-05