High-Quality, Low-Cost Gastrectomy Care at High-Volume Hospitals

Abstract

To evaluate associations among hospital volume, costs, and length of stay (LOS) and to assess whether reduced hospital cost of care adversely affected quality of care.

Long‐term metformin use reduces gastric cancer risk in type 2 diabetics without insulin treatment: a nationwide cohort study

“…This database is extensively used for epidemiological 24,25 and health policy studies. 26 The International Classification of Diseases 10th Revision codes 27 were used to identify type 2 diabetes (E11) and gastric cancer (C16). This study was approved by the Institutional Review Board of the National Cancer Center, Korea (NCCRE-11-003).…”

Diagnostic Value of Clinical T Staging Assessed by Endoscopy and Stomach Protocol Computed Tomography in Gastric Cancer: The Experience of a Low-Volume Institute

“…(16) Therefore, the patients have longer length of hospital stay and need more costs. There are a few reports about the surgical outcome of low volume hospital with acceptable result, but few studies report the diagnostic performance of low volume institute.…”

Are We Lacking Economic Evaluations in Gastric Cancer Treatment?

“…All studies assume clinical equipoise between treatment strategies and those that make statistical comparisons only do so with costs. A recent multivariate regression analysis performed by Lee et al [15] regarding the independent determinants of the cost of gastrectomies for gastric cancer found that multiple factors increased the cost associated with the procedure, including gender, age, Charlson score, and hospital volume. Interestingly, the mean cost of a gastrectomy at a high-volume hospital was significantly lower than at a low-volume hospital (US$2,578 vs. US$5,011; p \ 0.001) [15].…”

“…A recent multivariate regression analysis performed by Lee et al [15] regarding the independent determinants of the cost of gastrectomies for gastric cancer found that multiple factors increased the cost associated with the procedure, including gender, age, Charlson score, and hospital volume. Interestingly, the mean cost of a gastrectomy at a high-volume hospital was significantly lower than at a low-volume hospital (US$2,578 vs. US$5,011; p \ 0.001) [15]. Clinical evidence suggests that patients who receive surgical procedures for gastric cancer at high-volume specialized centers have better short-term outcomes than those who receive their care at low-volume institutions [16].…”

“…Clinical evidence suggests that patients who receive surgical procedures for gastric cancer at high-volume specialized centers have better short-term outcomes than those who receive their care at low-volume institutions [16]. Lee et al provide further evidence that for an expensive to treat cancer, such as gastric cancer, with a complex surgical procedure, the referral of patients to high-volume centers may improve not only the quality of care but also may be associated with lower treatment costs [15,16]. Whether or not this relationship would translate to different systems in a lowincidence country is unclear; however, it highlights an area worthy of future research to help inform policy.…”