Predictors of the cost of hysterectomy for benign indications

AlAshqar, Abdelrahman; Goktepe, Metin E.; Kılıç, Gökhan; Borahay, Mostafa A.

doi:10.1016/j.jogoh.2020.101936

Cited by 9 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With regards to cost, our finding of a significantly lower hysterectomy cost among patients discharged on the same day is supported by our previous study showing that each additional day in LOS increases procedure cost by US$3723.60. 4 In line with our results, previous studies have similarly reported that lower EBL, earlier procedure start time, and shorter OR time increase SDD likelihood. 13,14 OR time may be a surrogate marker for patient characteristics, case complexity, and operating surgeon's skills, which can explain the impact of operative time on hospital stay.…”

Section: Discussionsupporting

confidence: 92%

“…The anomaly seen in these 3 years may be explained by a cohort of patients with worse pathology or more comorbidities in that time period or a change in staff. With regards to cost, our finding of a significantly lower hysterectomy cost among patients discharged on the same day is supported by our previous study showing that each additional day in LOS increases procedure cost by US$3723.60 4 …”

Section: Discussionsupporting

confidence: 83%

“…For example, robotic hysterectomy is a significant predictor of SDD in our study; however, it is an inherently lengthy procedure and may therefore be prioritized over laparoscopic and vaginal cases, which have shorter case times. 4,23 Likewise, whereas BMI and uterine weight did not significantly impact SDD likelihood in this study, they should be incorporated into preoperative planning because their influence on SDD may be mediated through OR time. Case complexity is not easily tackled, but its impact on variables, such as EBL, operative time, and LOS, can be ameliorated through intensive simulation programs, improving surgeons' skills and team efficiency.…”

Section: Ta B L E 2 (Continued)mentioning

confidence: 58%

“…It has been shown that extended postoperative length of stay (LOS) is seldom attributed to surgical complications or patient comorbidities but is rather reflective of practice style differences 3 . Therefore, since LOS is also a significant predictor of hysterectomy cost, 4 gynecologists should scrutinize the need for longer postoperative hospitalization and assume additional roles in proper resource management, which can be feasible with MIH.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Predictors of same‐day discharge after minimally invasive hysterectomy for benign indications

AlAshqar

Wildey

Yazdy

et al. 2021

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

Objective: To identify predictors of same-day discharge after benign minimally invasive hysterectomy. Methods:In this retrospective cohort study, we identified women (n = 1084) undergoing benign minimally invasive hysterectomy from 2009 to 2016. Multivariate logistic regression was used to examine demographic, operative, and surgeon factors associated with discharge on postoperative day 0.Results: In our study population, 238 women (22%) were discharged on the same day.Robotic hysterectomy (risk ratio [RR] 2.24; 95% confidence interval [CI] 1.13-4.44), shorter operative time (lowest quartile; RR 5.28; 95% CI 2.66-10.46), and minimal blood loss (lowest quartile; RR 3.01; 95% CI 1.68-6.23) were associated with higher same-day discharge likelihood whereas later procedure start time (2-5 pm; RR 0.38; 95% CI 0.17-0.85) and postoperative complications (RR 0.19; 95% CI 0.06-0.55) significantly decreased its likelihood. The strongest predictor was surgeon's number of years in practice, with recently graduated surgeons more likely to discharge their patients on the same day (RR 3.15; 95% CI 2.09-4.77). Conclusion:Same-day discharge after minimally invasive hysterectomy is determined by several patient, operative, and surgeon factors that can be incorporated into an implementation plan to promote earlier discharge. Most especially, scheduling patients based on perceived case complexity and targeted surgeon education can qualify a larger cohort for same-day discharge.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 83%

Section: Ta B L E 2 (Continued)mentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of same‐day discharge after minimally invasive hysterectomy for benign indications

AlAshqar

Wildey

Yazdy

et al. 2021

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

show abstract

“… 34 , 35 A recent study demonstrated that the operating room time and the hospital length of stay appear to be potentially modifiable predictors of cost. 36 Another study provided specific strategies to cut waste in the operating room via parallel tasking, minimizing time, and minimizing the number of instruments used. 37 Also, outpatient surgeries appear to be safe with significant cost savings.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Minimally Invasive Myomectomy in the National Inpatient Sample Database, 2010–2014

Frost¹,

McMahon²,

Smith³

et al. 2021

JSLS

Self Cite

View full text Add to dashboard Cite

Background and Objectives: This study aims to characterize the utilization of minimally invasive myomectomy in the United States and to identify the patient and hospital factors associated with surgical approach to myomectomy. Methods: This is a cross-sectional study using the National Inpatient Sample database. We extracted women aged 18–50 years who underwent open and minimally invasive (laparoscopic and robotic) myomectomy (MIM) from January 1, 2010–December 31, 2014. Descriptive statistics were obtained for patient and hospital characteristics. We then performed multivariable logistic regression to examine the association of patient (age, race, insurance status, median household income) and hospital (bed size, teaching status, for-profit status, census region, cases volume) characteristics with the likelihood of undergoing MIM. Results: Of 114,850 myomectomy cases, 8,330 (7%) underwent MIM and 106,520 (93%) were open. Over time, the proportion of MIM remained very low and slightly decreased from 8.2% in 2010 to 6.1% in 2014 (p-for-trend: 0.001). Most hospitals performed few MIM per year, with 50% performing five or less, and 25% performing three or fewer per year. African American, Hispanic, and women of other races were less likely to undergo MIM compared to Caucasian women (adjusted odds ration [OR] 0.57, 95% confidence interval [CI] 0.50–0.64; 0.71, 95% CI 0.60–0.83; 0.62, 95% CI 0.52–0.74, respectively). Women in the West (adjusted odds ratio (aOR) 1.23, 95% CI 1.04–1.46) and Midwest (aOR 1.27, 95% CI 1.07–1.52) had higher odds of undergoing MIM. Conclusion: MIM appears to be an underutilized modality, accounting for less than10% of myomectomies. This underutilization disproportionally affects minority women.

show abstract

Cost drivers for benign hysterectomy within a health care system: Influence of patient, perioperative, and hospital factors

Kohn

Frost

Tambovtseva

et al. 2022

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

Objective: To identify patient, perioperative, and hospital factors that drive total hospital charges for benign hysterectomy. Methods:The authors conducted a retrospective cohort study between July 2014 and February 2019 at five academic and community hospitals within an integrated healthcare system in the state of Maryland with a Global Budget Revenue methodology for hospital charges. Predictor variables included patient, perioperative and hospital characteristics. One-way analysis of variance was used to compare charges among approaches. A multiple linear regression model was built to account for the interaction between covariates.Results: A total of 2592 patients underwent hysterectomy via laparoscopic (61%), abdominal (16%), robotic (14%), or vaginal (9%) approaches. Before adjusting for covariates, laparoscopic and vaginal approaches had similar charges

show abstract

Predictors of the cost of hysterectomy for benign indications

Cited by 9 publications

References 27 publications

Predictors of same‐day discharge after minimally invasive hysterectomy for benign indications

Predictors of same‐day discharge after minimally invasive hysterectomy for benign indications

Predictors of Minimally Invasive Myomectomy in the National Inpatient Sample Database, 2010–2014

Cost drivers for benign hysterectomy within a health care system: Influence of patient, perioperative, and hospital factors

Contact Info

Product

Resources

About