Procedural volume, cost, and reimbursement of outpatient incisional hernia repair: implications for payers and providers

Song, Chao; Liu, Emelline; Tackett, S.; Shi, Lizheng; Marcus, Daniel R.

doi:10.1080/13696998.2017.1294596

Cited by 7 publications

(1 citation statement)

References 26 publications

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“…In addition, our results could have been biased since NIS database only looks at inpatient samples. Majority of ventral hernia repairs can now be done as outpatient, and as study done by Chao et al shows, out of the 106,552 cases of elective ventral hernia repair done between 2008 and 2015, 58% were ambulatory case [15]. NIS database would not have captured these ambulatory cases.…”

Section: Discussionmentioning

confidence: 99%

It’s not just an ileus: disparities associated with ileus following ventral hernia repair

Lee

Sugiyama

Alfonso

et al. 2020

Hernia

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Purpose We sought to identify risk factors associated with postoperative ileus following ventral hernia repair. Methods Utilizing the Nationwide Inpatient Sample (NIS) from 2008 to 2012, we identified adult patients that underwent either open or laparoscopic hernia repair for umbilical and ventral hernias with a diagnosis of umbilical/ventral hernia. We excluded cases with diagnosis of obstruction and bowel gangrene that underwent bowel resection, or with missing data. Risk variables of interest were age, sex, race, income status, insurance status, elective admission, comorbidity status (using the validated van Walraven Score), complications (mechanical, respiratory, postoperative infection, cardiovascular, intraoperative), morbid obesity, procedure type, conversion to open, mesh use, hospital type (rural, urban non-teaching, urban teaching), bed size, and region (northeast, midwest, south, west). Univariate analysis comparing patients with ileus vs control was performed. We then performed multivariable analysis using logistic regression, adjusting for all the risk variables, with ileus as the dependent variable. Results 30,912 patients were identified that met criteria. Of these, 2660 (8.61%) had postoperative ileus during their stay at the hospital. Univariate analysis showed all risk variables were associated with development of ileus with the exception of income status (p = 0.2903), elective admission (p = 0.7989), mesh use (p = 0.3620), and hospital bed size (p = 0.08351). Median length of stay was 7 days in the ileus cohort vs 3 days in control (p < 0.0001). Median total charges (adjusted to 2012 dollars) was $54,819 vs $35,058 (p < 0.0001). We then performed logistic regression adjusting for all risk variables and found that age (OR 1.66, p < 0.0001), male sex (OR 1.51, p < 0.0001), Black race (OR 1.49, p < 0.0001), comorbidity status (OR 1.12, p < 0.0001), laparoscopic cases converted to open (OR 1.55, p < 0.0001), postoperative complications (mechanical:

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Section: Discussionmentioning

confidence: 99%