The Economic Burden of Complications Occurring in Major Surgical Procedures: a Systematic Review

Abstract

The overall conclusions of included studies are consistent: complications represent an important economic burden for health care providers. We conclude that more accurate and consistent data collection is required to serve as input for good-quality economic analyses, which in turn can inform hospital decisions on cost-efficient allocation of their limited resources.

Health economic implications of postoperative complications following liver resection surgery: a systematic review

“…The development of post‐operative liver failure was associated with the highest costs. Our review found strong evidence concerning the association of length of stay with costs, a finding supported by others …”

“…Our review found strong evidence concerning the association of length of stay with costs, a finding supported by others. 23 Large variations in the inclusiveness of hospital cost existed across the studies, with some studies opting to report charges as opposed to hospital cost. This proved problematic for comparison between studies, as charges are a poor substitution for hospital cost, given the considerable variation seen between healthcare systems and even hospitals in the same healthcare system.…”

Hospital quality, patient risk, and Medicare expenditures for cancer surgery

“…[6][7][8] The cost of surgical resection varies by as much as 130% between hospitals. 5 Because inpatient surgical costs are largely driven by the occurrence of postoperative complications, [9][10][11][12][13] cost variation is intimately related to hospital quality. 14 A patient's age, comorbidities, and functional status may also affect the costs of care by affecting both a patient's likelihood of experiencing a complication and the difficulty of subsequent recovery.…”

Assessment of health care cost for complex surgical patients: review of cost, re-imbursement and revenue involved in pancreatic surgery at a high-volume academic medical centre

“…The cost of pancreatic surgery has been found to be associated with complications, surgeon experience, post‐operative pathways, volume and type of operation. For example, post‐operative complications have been found to be consistently associated with increased hospital costs . In contrast, factors associated with decreased costs include hospital volume, clinical pathways and surgeon experience …”

“…For example, post-operative complications have been found to be consistently associated with increased hospital costs. 8,14,15 In contrast, factors associated with decreased costs include hospital volume, 15 clinical pathways 16 and surgeon experience. 17 Although Vollmer reported significant programmatic revenue for a high-volume programme, he did not describe the relationship between clinical factors and revenue.…”