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Surgeon Variability Impacts Costs in Laparoscopic Cholecystectomy: the Volume-Cost Relationship.

Publication ,  Journal Article
Stahl, CC; Udani, S; Schwartz, PB; Aiken, T; Acher, AW; Barrett, JR; Greenberg, JA; Abbott, DE
Published in: J Gastrointest Surg
January 2021

BACKGROUND: Physician variation in adherence to best practices contributes to the high costs of health care. Understanding surgeon-specific cost variation in common surgical procedures may inform strategies to improve the value of surgical care. METHODS: Laparoscopic cholecystectomies at a single institution were identified over a 5-year period and linked to an institutional cost database. Multiple linear regression was used to control for patient-, case-, and hospital-specific factors while assessing the impact of surgeon variability on cost. RESULTS: The final dataset contained 1686 patients. Higher surgeon volume (reported in tertiles) was associated with decreased costs ($5354 vs. $6301 vs. $7156, p < 0.01) and OR times (66 min vs. 85 min vs. 95 min, p < 0.01). After controlling for patient-, case-, and hospital-specific factors, non-MIS fellowship training type (p < 0.01) and low surgeon volume (p < 0.01) were associated with increased costs, while time in practice did not contribute to cost variation (p = NS). CONCLUSIONS: Surgeon variability contributes to costs in laparoscopic cholecystectomy. Some of this variability is associated with operative volume and fellowship training. Collaboration to limit this cost variability may reduce surgical resource utilization.

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Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

January 2021

Volume

25

Issue

1

Start / End Page

195 / 200

Location

United States

Related Subject Headings

  • Surgery
  • Surgeons
  • Multivariate Analysis
  • Linear Models
  • Humans
  • Hospitals
  • Cholecystectomy, Laparoscopic
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Stahl, C. C., Udani, S., Schwartz, P. B., Aiken, T., Acher, A. W., Barrett, J. R., … Abbott, D. E. (2021). Surgeon Variability Impacts Costs in Laparoscopic Cholecystectomy: the Volume-Cost Relationship. J Gastrointest Surg, 25(1), 195–200. https://doi.org/10.1007/s11605-020-04814-0
Stahl, Christopher C., Shreyans Udani, Patrick B. Schwartz, Taylor Aiken, Alexandra W. Acher, James R. Barrett, Jacob A. Greenberg, and Daniel E. Abbott. “Surgeon Variability Impacts Costs in Laparoscopic Cholecystectomy: the Volume-Cost Relationship.J Gastrointest Surg 25, no. 1 (January 2021): 195–200. https://doi.org/10.1007/s11605-020-04814-0.
Stahl CC, Udani S, Schwartz PB, Aiken T, Acher AW, Barrett JR, et al. Surgeon Variability Impacts Costs in Laparoscopic Cholecystectomy: the Volume-Cost Relationship. J Gastrointest Surg. 2021 Jan;25(1):195–200.
Stahl, Christopher C., et al. “Surgeon Variability Impacts Costs in Laparoscopic Cholecystectomy: the Volume-Cost Relationship.J Gastrointest Surg, vol. 25, no. 1, Jan. 2021, pp. 195–200. Pubmed, doi:10.1007/s11605-020-04814-0.
Stahl CC, Udani S, Schwartz PB, Aiken T, Acher AW, Barrett JR, Greenberg JA, Abbott DE. Surgeon Variability Impacts Costs in Laparoscopic Cholecystectomy: the Volume-Cost Relationship. J Gastrointest Surg. 2021 Jan;25(1):195–200.
Journal cover image

Published In

J Gastrointest Surg

DOI

EISSN

1873-4626

Publication Date

January 2021

Volume

25

Issue

1

Start / End Page

195 / 200

Location

United States

Related Subject Headings

  • Surgery
  • Surgeons
  • Multivariate Analysis
  • Linear Models
  • Humans
  • Hospitals
  • Cholecystectomy, Laparoscopic
  • 3202 Clinical sciences
  • 1103 Clinical Sciences