Skip to main content
Journal cover image

Hospital Volume and the Costs Associated with Surgery for Pancreatic Cancer.

Publication ,  Journal Article
Gani, F; Johnston, FM; Nelson-Williams, H; Cerullo, M; Dillhoff, ME; Schmidt, CR; Pawlik, TM
Published in: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
September 2017

Data evaluating the financial implications of volume-based referral are lacking. This study sought to compare in-hospital costs for pancreatic surgery by annual hospital volume.Eleven thousand and eighty-one patients aged ≥18 years undergoing an elective pancreatic resection for cancer were identified using the Nationwide Inpatient Sample 2002-2011. Multivariable regression analysis was performed to compare length-of-stay (LOS), postoperative morbidity and mortality, failure-to-rescue (FTR), and inpatient costs by annual hospital volume group.Patients undergoing surgery at high-volume hospitals (HVH) demonstrated 23% lower odds (odds ratio [OR] = 0.77, 95% confidence interval [95%CI] 0.63-0.95) of developing a postoperative complication, 59% lower odds of experiencing an LOS > 14 days (OR = 0.41, 95%CI 0.34-0.50), 51% lower odds of postoperative mortality (OR = 0.49, 95%CI 0.34-0.71), and 47% lower odds of FTR (OR = 0.53, 95%CI 0.37-0.76; all p<0.05). The overall mean in-hospital cost was $39,012 (SD = $15,214) with minimal differences observed across hospital volume groups. Rather, postoperative complications (no complication vs. complication $26,686 [SD = $5762] vs. $44,633 [SD = $11,637]) and FTR (rescue vs. FTR $42,413 [SD = $8481] vs. $69,546 [SD = $13,131]) were determinant of higher in-hospital costs. While this pattern was observed at all hospital volume groups, costs varied minimally between hospital volume groups after this stratification.Annual hospital surgical volume was not associated with in-hospital costs among patients undergoing pancreatic surgery.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

DOI

EISSN

1873-4626

ISSN

1091-255X

Publication Date

September 2017

Volume

21

Issue

9

Start / End Page

1411 / 1419

Related Subject Headings

  • Surgery
  • Postoperative Complications
  • Pancreatic Neoplasms
  • Pancreatectomy
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitals, Low-Volume
  • Hospitals, High-Volume
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gani, F., Johnston, F. M., Nelson-Williams, H., Cerullo, M., Dillhoff, M. E., Schmidt, C. R., & Pawlik, T. M. (2017). Hospital Volume and the Costs Associated with Surgery for Pancreatic Cancer. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, 21(9), 1411–1419. https://doi.org/10.1007/s11605-017-3479-x
Gani, Faiz, Fabian M. Johnston, Howard Nelson-Williams, Marcelo Cerullo, Mary E. Dillhoff, Carl R. Schmidt, and Timothy M. Pawlik. “Hospital Volume and the Costs Associated with Surgery for Pancreatic Cancer.Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract 21, no. 9 (September 2017): 1411–19. https://doi.org/10.1007/s11605-017-3479-x.
Gani F, Johnston FM, Nelson-Williams H, Cerullo M, Dillhoff ME, Schmidt CR, et al. Hospital Volume and the Costs Associated with Surgery for Pancreatic Cancer. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 2017 Sep;21(9):1411–9.
Gani, Faiz, et al. “Hospital Volume and the Costs Associated with Surgery for Pancreatic Cancer.Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, vol. 21, no. 9, Sept. 2017, pp. 1411–19. Epmc, doi:10.1007/s11605-017-3479-x.
Gani F, Johnston FM, Nelson-Williams H, Cerullo M, Dillhoff ME, Schmidt CR, Pawlik TM. Hospital Volume and the Costs Associated with Surgery for Pancreatic Cancer. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 2017 Sep;21(9):1411–1419.
Journal cover image

Published In

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

DOI

EISSN

1873-4626

ISSN

1091-255X

Publication Date

September 2017

Volume

21

Issue

9

Start / End Page

1411 / 1419

Related Subject Headings

  • Surgery
  • Postoperative Complications
  • Pancreatic Neoplasms
  • Pancreatectomy
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitals, Low-Volume
  • Hospitals, High-Volume