Outcomes of Complex Gastrointestinal Cancer Resection at US News &amp; World Report Top-Ranked vs Non-Ranked Hospitals

Tay, Erika; Gambhir, Sahil; Stopenski, Stephen; Hohmann, Samuel F.; Smith, Brian R.; Daly, Shaun; Hinojosa, Marcelo W.; Nguyen, Ninh T.

doi:10.1016/j.jamcollsurg.2021.02.012

Cited by 2 publications

(1 citation statement)

References 16 publications

(14 reference statements)

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“…Ongoing efforts will persist in enhancing the centralization of complex cancer treatment, including surgery. Public reporting of hospital performance evaluations, such as U.S. News Ranking and Vizient, 134 , 135 , 136 naturally drives patients to seek healthcare at top‐rated hospitals with reported better outcomes. The volume‐outcomes relationship continues to exist, especially for highly specialized operations such as robotic surgical oncology.…”

Section: Future Studies Of Robotic Surgical Oncology In Value‐based Carementioning

confidence: 99%

What defines the “value” of robotic surgery for patients with gastrointestinal cancers? Perspectives from a U.S. Cancer Center

Ikoma

2024

Annals of Gastroent Surgery

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The use of robotic surgery has experienced rapid growth across diverse medical conditions, with a notable emphasis on gastrointestinal cancers. The advanced technologies incorporated into robotic surgery platforms have played a pivotal role in enabling the safe performance of complex procedures, including gastrectomy and pancreatectomy, through a minimally invasive approach. However, there exists a noteworthy gap in high‐level evidence demonstrating that robotic surgery for gastric and pancreatic cancers has substantial benefits compared to traditional open or laparoscopic methods. The primary impediment hindering the broader implementation of robotic surgery is its cost. The escalating healthcare expenses in the United States have prompted healthcare providers and payors to explore patient‐centered, value‐based healthcare models and reimbursement systems that embrace cost‐effectiveness. Thus, it is important to determine what defines the value of robotic surgery. It must either maintain or enhance oncological quality and improve complication rates compared to open procedures. Moreover, its true value should be apparent in patients' expedited recovery and improved quality of life. Another essential aspect of robotic surgery's value lies in minimizing or even eliminating opioid use, even after major operations, offering considerable benefits to the broader public health landscape. A quicker return to oncological therapy has the potential to improve overall oncological outcomes, while a speedier return to work not only alleviates individual financial distress but also positively impacts societal productivity. In this article, we comprehensively review and summarize the current landscape of health economics and value‐based care, with a focus on robotic surgery for gastrointestinal cancers.

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Section: Future Studies Of Robotic Surgical Oncology In Value‐based Carementioning

confidence: 99%

What defines the “value” of robotic surgery for patients with gastrointestinal cancers? Perspectives from a U.S. Cancer Center

Ikoma

2024

Annals of Gastroent Surgery

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Clinical Outcomes, Costs, and Value of Surgery Among Older Patients with Colon Cancer at US News and World Report Ranked Versus Unranked Hospitals

Altaf,

Woldesenbet,

Munir

et al. 2024

Ann Surg Oncol

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Background US News and World Report (USNWR) hospital rankings influence patient choice of hospital, but their association with surgical outcomes remains ill-defined. We sought to characterize clinical outcomes and costs of surgery for colon cancer among USNWR top ranked and unranked hospitals. Methods Using Medicare Standard Analytic Files, patients aged ≥65 years undergoing surgery for colon cancer were identified. Hospitals were categorized as ‘ranked’ or ‘unranked’ based on USNWR cancer hospital rankings. One-to-one matching was performed between patients treated at ranked and unranked hospitals, and clinical outcomes and costs of surgery were compared. Results Among 50 ranked and 2522 unranked hospitals, 13,650 patient pairs were compared. Overall, 30-day mortality was 2.13% in ranked hospitals versus 3.68% in unranked hospitals (p < 0.0001), and the overall paired cost difference was $8159 (p < 0.0001). As patient risk increased, 30-day mortality differences became larger, with the ranked hospitals having 30-day mortality of 7.59% versus 11.84% for unranked hospitals among the highest-risk patients (p < 0.0001). Overall paired cost differences also increased with increasing patient risk, with cost of care being $72,229 for ranked hospitals versus $56,512 for unranked hospitals among the highest-risk patients (difference = $14,394; p = 0.02). The difference in cost per 1% reduction in 30-day mortality was $9009 (95% confidence interval [CI] $6422–$11,597) for lowest-risk patients, which dropped to $3387 (95% CI $2656–$4119) for highest-risk patients (p < 0.0001). Conclusion Treatment at USNWR-ranked hospitals, particularly for higher-risk patients, was associated with better outcomes but higher-cost care. The benefit of being treated at highly ranked USNWR hospitals was most pronounced among high-risk patients.

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Outcomes of Complex Gastrointestinal Cancer Resection at US News & World Report Top-Ranked vs Non-Ranked Hospitals

Cited by 2 publications

References 16 publications

What defines the “value” of robotic surgery for patients with gastrointestinal cancers? Perspectives from a U.S. Cancer Center

What defines the “value” of robotic surgery for patients with gastrointestinal cancers? Perspectives from a U.S. Cancer Center

Clinical Outcomes, Costs, and Value of Surgery Among Older Patients with Colon Cancer at US News and World Report Ranked Versus Unranked Hospitals

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