Association of postoperative complications with hospital costs and length of stay in a tertiary care center

Khan, Nadia; Quan, Hude; Bugar, Jennifer M.; Lemaire, Jane B; Brant, Rollin; Ghali, William A.

doi:10.1007/s11606-006-0254-1

Cited by 233 publications

(145 citation statements)

References 15 publications

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…In a Canadian study, average medical costs were CA$2503 [approximately £1615 (cost correct as of 2010)] with a further CA$2677 [approximately £1727 (cost correct as of 2010)] attributable to non-medical costs including loss of earnings, assistance and transport. 181 Khan and colleagues 182 estimated that complications after non-cardiac surgery may lead to increases in hospital stays of 114%, with significant associated hospital costs.…”

Section: Resultsmentioning

confidence: 99%

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

View full text Add to dashboard Cite

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms PROGRAMME GRANTS FOR APPLIED RESEARCH VOLUME 4 ISSUE 12 AUGUST 2016 ISSN 2050 DOI 10.3310/pgfar04120Improving patients' experience and outcome of total joint replacement: the RESTORE programme Ashley W Blom, Neil Artz, Andrew D Beswick, Amanda Burston, Paul Dieppe, Karen T Elvers, Rachael Gooberman-Hill, Jeremy Horwood, Paul Jepson, Emma Johnson, Erik Lenguerrand, Elsa Marques, Sian Noble, Mark Pyke, Catherine Sackley, Gina Sands, Adrian Sayers, Victoria Wells and Vikki Wylde Improving patients' experience and outcome of total joint replacement: the RESTORE programme ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10070. The contractual start date was in December 2008. The final report began editorial review in September 2014 and was accepted for publication in August 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accurac...

show abstract

Section: Resultsmentioning

confidence: 99%

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

View full text Add to dashboard Cite

show abstract

“…We first identified a total of 161 post-operative complications in abdominal surgery from our prospectively managed database and the literature [8-10]. Five board certified senior staff surgeons checked the list for completeness and estimated independently the frequency as well as the relevance of these complications on a Likert-type scale from 1 (very infrequent respectively not relevant) to 6 (very frequent respectively very relevant).…”

Section: Methodsmentioning

confidence: 99%

Perception of surgical complications among patients, nurses and physicians: a prospective cross-sectional survey

et al. 2011

View full text Add to dashboard Cite

BackgroundSeveral scores grade the severity of post-operative complications but it is unclear whether such scores truly reflect the perception of patients and practicing nurses and physicians.Study Design227 patients, 143 nurses and 245 physicians independently rated the severity of 30 common post-operative complications on a numerical analogue scale from 0 (not severe at all) to 100 (extremely severe) while being blinded towards the Clavien-Dindo classification. We considered a difference in ratings of >10 to be clinically important in distinguishing between grades of severity and groups. We evaluated the level of reproducibility of responses by calculating intraclass correlation coefficients (ICC) and compared scores across severity grades and between groups using the generalized estimating equations.ResultsReproducibility of the ratings was good for all three groups (ICCpatients 0.71 (95%-CI 0.64-0.76), ICCnurses 0.83 (0.78-0.87) and ICCphysicians 0.87 (0.83-0.90)). The participants' perceptions of the severity of complications reflected the Clavien-Dindo classification (median of grade I: 20 (IQR 10-30), grade II: 40 (31.3-52.5), grade IIIa: 50 (40-60), grade IIIb: 70 (60-75), grade IVa: 85 (80-90) and grade IVB: 95 (90-100)). Although patients' perception differed significantly from those of physicians (average difference -8.7 (95%-CI -10.4 to -6.9, p < 0.001) and nurses (difference -2.8 (-4.8 to -0.8, p = 0.007) they did not reach our thresholds for clinical importance.ConclusionsThe severity of post-operative complications is perceived similarly by patients, nurses and physicians and reflects the Clavien-Dindo classification well. Our results support the use of Clavien-Dindo classification system as part of the shared or informed decision making process.

show abstract

“…The incidence of postoperative complications in patients subjected to colorectal surgery has been shown to vary between 17% and 31% in investigations of both elective and emergent procedures [4,5]. In recent reports, postoperative complications increased health care costs and resource utilization [6,7]. In support of those observations, Soop et al [8] noted that adverse effects were common and caused significant consumption of healthcare resources in Swedish hospitals, although hospital costs per se were not reported.…”

Section: Introductionmentioning

confidence: 99%

Hospital costs associated with surgical morbidity after elective colorectal procedures: a retrospective observational cohort study in 530 patients

Zoucas

Lydrup

2014

Patient Saf Surg

View full text Add to dashboard Cite

BackgroundPostoperative complications contribute to morbidity and mortality. This study assessed the impact of surgical complications on healthcare resource utilization for patients undergoing elective colorectal procedures.MethodData were obtained on 530 consecutive colorectal operations performed from January 2010 to January 2011. Patient demographics, type of procedure, surgical complications classified as Clavien 1–5, length of stay, 60-day readmission rate, and hospital costs were recorded.ResultsSeventy-five percent of the operations were associated with malignancy, and 26% were pelvic procedures. Thirty-five percent of the patients developed at least one complication, 21% of the complications did not require intervention. The readmission rate was 7.4%. Nine patients died during 60-day post discharge follow up.Median length of stay was 9 (3–34) days in uncomplicated and 16 (4–205) days in complicated cases. Occurrence of any complication at index admission increased total hospital costs 2.1-fold (EUR 25,680 vs. EUR 12,405), with the largest cost differential attributed to wound dehiscence and/or suture line failure requiring reoperation. These increases were primarily due to prolonged hospitalization and ICU expenditures. Readmission resulted in a further increase to an average cost of EUR 12,585 per re-admitted patient.Multivariate analysis showed that BMI > 25, obesity, operation complexity and surgeon significantly affected the risk for complication. Also, hospital costs were significantly increased by any postoperative complications, reoperations, high complexity of surgical procedures and high comorbidity index.ConclusionsReducing morbidity after colorectal procedures improves quality of care and patient safety, and may also substantially reduce hospital costs and increase the efficiency of resource utilization.

show abstract

Association of postoperative complications with hospital costs and length of stay in a tertiary care center

Abstract: Postoperative complications consume considerable health care resources. Initiatives targeting prevention of these events could significantly reduce overall costs of care and improve patient quality of care.

Cited by 233 publications

References 15 publications

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Perception of surgical complications among patients, nurses and physicians: a prospective cross-sectional survey

Hospital costs associated with surgical morbidity after elective colorectal procedures: a retrospective observational cohort study in 530 patients

Contact Info

Product

Resources

About