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The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think

BACKGROUND: There is increasing public discussion about the escalating cost of healthcare in America. There are no published data regarding the contribution of individual surgeons’ choices on the cost of uncomplicated minimally invasive colectomy. METHODS: A review of a hospital cost-accounting data...

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Autores principales: Tillou, John, Nagle, Deborah, Poylin, Vitaliy, Cataldo, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952919/
https://www.ncbi.nlm.nih.gov/pubmed/29780598
http://dx.doi.org/10.1093/gastro/gox035
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author Tillou, John
Nagle, Deborah
Poylin, Vitaliy
Cataldo, Thomas
author_facet Tillou, John
Nagle, Deborah
Poylin, Vitaliy
Cataldo, Thomas
author_sort Tillou, John
collection PubMed
description BACKGROUND: There is increasing public discussion about the escalating cost of healthcare in America. There are no published data regarding the contribution of individual surgeons’ choices on the cost of uncomplicated minimally invasive colectomy. METHODS: A review of a hospital cost-accounting database of the direct costs related to the index operation and post-operative care of all patients who underwent elective minimally invasive segmental colectomy over a 1-year period was performed. RESULTS: A total of 111 cases were enrolled in this study, 18 of which were performed robotically. The average direct cost after minimally invasive colectomy was $5536. The cost of robotic colectomy was 53% greater than laparoscopic ($7806 vs $5096, p < 0.001). There was no statistically significant difference in overall costs among laparoscopic cases performed by three surgeons ($5099 vs $5108 vs $5055, p = 0.987). Average operating room supply costs among the three surgeons were $1236, $1105 and $1030, respectively (p = 0.067), with a standard deviation of $328 (6.4% of overall cost). CONCLUSIONS: No significant difference in overall costs between surgeons was demonstrated despite varied training, experience levels and operative techniques. Total costs are relatively institutionally fixed and minimally influenced by variations in individual surgeon preferences.
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spelling pubmed-59529192018-05-18 The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think Tillou, John Nagle, Deborah Poylin, Vitaliy Cataldo, Thomas Gastroenterol Rep (Oxf) Original Articles BACKGROUND: There is increasing public discussion about the escalating cost of healthcare in America. There are no published data regarding the contribution of individual surgeons’ choices on the cost of uncomplicated minimally invasive colectomy. METHODS: A review of a hospital cost-accounting database of the direct costs related to the index operation and post-operative care of all patients who underwent elective minimally invasive segmental colectomy over a 1-year period was performed. RESULTS: A total of 111 cases were enrolled in this study, 18 of which were performed robotically. The average direct cost after minimally invasive colectomy was $5536. The cost of robotic colectomy was 53% greater than laparoscopic ($7806 vs $5096, p < 0.001). There was no statistically significant difference in overall costs among laparoscopic cases performed by three surgeons ($5099 vs $5108 vs $5055, p = 0.987). Average operating room supply costs among the three surgeons were $1236, $1105 and $1030, respectively (p = 0.067), with a standard deviation of $328 (6.4% of overall cost). CONCLUSIONS: No significant difference in overall costs between surgeons was demonstrated despite varied training, experience levels and operative techniques. Total costs are relatively institutionally fixed and minimally influenced by variations in individual surgeon preferences. Oxford University Press 2018-05 2017-09-27 /pmc/articles/PMC5952919/ /pubmed/29780598 http://dx.doi.org/10.1093/gastro/gox035 Text en © The Author(s) 2017. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-Sen University http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Tillou, John
Nagle, Deborah
Poylin, Vitaliy
Cataldo, Thomas
The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think
title The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think
title_full The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think
title_fullStr The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think
title_full_unstemmed The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think
title_short The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think
title_sort impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy: you are not as important as you think
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952919/
https://www.ncbi.nlm.nih.gov/pubmed/29780598
http://dx.doi.org/10.1093/gastro/gox035
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