Costs of complications after colorectal cancer surgery in the Netherlands: Building the business case for hospitals

Govaert, Johannes A.; Fiocco, Marta; Dijk, W.A. van; Scheffer, Alexander C.; Tollenaar, Rob A.E.M.; Wouters, Michel W. J. M.; Lamme, Bas; Hess, Daniël A.; Belgers, H. J.; Guicherit, Onno R.; Rosman, Camiel; Rutten, H.J.T.; Versluijs-Ossewaarde, F.N.L.; Zaag, Edwin S. van der; Tseng, L. N. L.; Graaf, Eelco J. R. de; Vles, Wouter J.; Pierik, E.G.J.M.; Prins, Hubert A.; Reemst, P. H. M.; Consten, E.C.J.; Koopal, Sietze A.; Neijenhuis, Peter A.; Mannaerts, Guido H. H.; Smits, Anke B.; Bürger, D.; Ijken, M G A van; Poortman, Pieter; Govaert, Marc J. P. M.; Bleeker, Wim; Boer, Frank C. den; Wit, Fennie; Kruyt, Ph.M.; Mearadji, A.; Heikens, Joost T.

doi:10.1016/j.ejso.2015.03.236

Cited by 65 publications

(59 citation statements)

References 19 publications

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“…Probably, the most straightforward explanation is that this group of patients experiences the comorbidities listed in Table I. High age itself (or other factors not listed in the DSCA) may be responsible for this increase as well, as shown by an earlier study of our group analyzing independent risk factors for severe complications after colorectal cancer surgery [4]. Poor outcomes in the oldest old might also be related to the higher number of emergency resections compared to patients under 85 years old (22% vs. 13%, Table I).…”

Section: Discussionmentioning

confidence: 85%

Hospital costs of colorectal cancer surgery for the oldest old: A Dutch population‐based study

Govaert

Fiocco

et al. 2016

Journal of Surgical Oncology

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Background Due to increasing healthcare costs, discussions regarding increased hospital costs when operating on high‐risk patients is rising. Therefore, the aim of this study was to analyze if oldest‐old colorectal cancer patients have a greater impact on hospital costs than their younger counterparts. Methods All colorectal cancer procedures performed in 29 Dutch hospitals between 2010 and 2012 and listed in the Dutch Surgical Colorectal Audit were analyzed. Oldest‐old patients (≥85 years) were compared to patients <85 years. Ninety‐day hospital costs were measured uniformly in all hospitals based on time‐driven activity‐based costs. Results Compared to <85‐year‐old patients (n = 9130), the oldest old (n = 783) had longer hospital stays (LOS) (11.3 vs. 13.2, P < 0.001), more severe complications (21.8% vs. 29.0%, P < 0.001), more failure to rescue (13.9% vs. 37.0%, P < 0.001) and higher mortality (3.0% vs. 10.7%, P < 0.001). Deceased oldest‐old patients had significantly less LOS and less LOS ICU. Total hospital costs were 3% lower for oldest‐old patients (€13,168) than for <85‐year‐old patients (€13,644, P < 0.001). In cases of severe complications or death, hospital costs for the oldest old were 25% and 31% lower than those of <85‐year‐old patients (both P < 0.001). Conclusion Although frequently assumed to be more expensive, operating on oldest‐old patients with colorectal cancer does not increase hospital costs compared to younger patients. This was most likely due to faster deterioration or less aggressive treatment of oldest‐old patients when (severe) complications occurred. J. Surg. Oncol. 2016;114:1009–1015. © 2016 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 85%

Hospital costs of colorectal cancer surgery for the oldest old: A Dutch population‐based study

Govaert

Fiocco

et al. 2016

Journal of Surgical Oncology

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“…Among the most frequent complications are pulmonary and circulatory complications and it is estimated that 10 million patients experience myocardial injury after noncardiac surgery (MINS) each year . Prevention or early intervention of these complications would thus make a major difference in morbidity and mortality after abdominal surgery and cause economic savings . In an attempt to identify patients at risk of complications, standardized protocols like the Early Warning Score (EWS) have been implemented in several European countries.…”

Section: Introductionmentioning

confidence: 99%

Continuous vital sign monitoring after major abdominal surgery—Quantification of micro events

Duus

Aasvang

Olsen

et al. 2018

Acta Anaesthesiol Scand

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“…DICAregistraties worden vanaf 2017 volledig gefinancierd door Zorgverzekeraars Nederland, waarbij de kosten voor deelnemende instellingen beperkt worden tot die van het datamanagement. Bij andere kwaliteitsregistraties is dit anders of zelfs niet geregeld, terwijl recent onderzoek laat zien dat kwaliteitsregistraties leiden tot aanzienlijke kostenbesparingen in de ziekenhuizen, onder andere door vermindering van kosten voor de opvang van complicaties (minder beeldvorming, heroperaties en opnamedagen, en korter verblijf op de intensive care) [28,29].…”

Section: Financieringunclassified

Kwaliteitsregistraties volgens het principe van ‘clinical auditing’

Wouters

2017

Tijdschr Urol

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Samenvatting Wetenschappelijke verenigingen van medisch specialisten hebben de afgelopen jaren kwaliteitsregistraties geïnitieerd die zijn opgezet volgens het clinical-auditing principe. Het primaire doel van deze landelijke audits is het verbeteren van zorguitkomsten, door behandelaars te voorzien van spiegelinformatie, waarmee zij de kwaliteit van hun zorgproces kunnen monitoren en verbeteren. Directe betrokkenheid van dokters bij de opzet en uitvoering van de audit, tijdige terugkoppeling van kwaliteitsaspecten die door henzelf belangrijk worden gevonden en het proactief volgen van ontwikkelingen in de zorg, zijn essentieel voor het succes van kwaliteitsregistraties. De mogelijkheid voor behandelaars om resultaten te monitoren, richtlijnnavolging en de introductie van de mogelijkheid om nieuwe technieken te evalueren en met kwaliteitsintiatieven hun uitkomsten te verbeteren, heeft tot substantiële vermindering van morbiditeit en mortaliteit geleid op diverse chirurgische terreinen. Registratie aan de bron, structurele financiering en goede afspraken over transparantie, zijn essentieel om clinical auditing te bestendigen als krachtig instrument in het kwaliteitsbeleid van wetenschappelijke verenigingen.

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Costs of complications after colorectal cancer surgery in the Netherlands: Building the business case for hospitals

Cited by 65 publications

References 19 publications

Hospital costs of colorectal cancer surgery for the oldest old: A Dutch population‐based study

Hospital costs of colorectal cancer surgery for the oldest old: A Dutch population‐based study

Continuous vital sign monitoring after major abdominal surgery—Quantification of micro events

Kwaliteitsregistraties volgens het principe van ‘clinical auditing’

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