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Frequency with which surgeons undertake pancreaticoduodenectomy determines length of stay, hospital charges, and in-hospital mortality.
- Source :
-
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2001 Jan-Feb; Vol. 5 (1), pp. 21-6. - Publication Year :
- 2001
-
Abstract
- Others have suggested that in certain technically challenging operations, outcome and experience are related. Because pancreaticoduodenectomy is a technically complex procedure, this study was undertaken to evaluate mortality, length of hospital stay, and hospital charges when compared to volume of experience. The database of the State of Florida Agency for Health Care Administration was queried for pancreaticoduodenectomies undertaken during a recent 33-month period. Length of stay, hospital charges, and in-hospital mortality were stratified by the frequency of pancreaticoduodenectomy. A total of 282 surgeons performed 698 pancreaticoduodenectomies over 33 months. Eighty-nine percent of surgeons performed one pancreaticoduodenectomy per year or less and accounted for 52% of the procedures. Overall mortality rate was 5.1%. Average hospital charges were $72,171.64. The more frequently pancreaticoduodenectomy was undertaken, the shorter the hospital stay (P = 0.025, regression analysis) and the lower the hospital charges (P = 0.008, regression analysis) and in-hospital mortality (P = 0.036, log likelihood ratio test). Surgeons who undertake pancreaticoduodenectomy more frequently have patients with shorter hospital stays, lower hospital charges, and lower in-hospital mortality rates, independent of hospital volume. Variations exist among surgeons and among different areas of the state. Data regarding cost and mortality are available for use in programs of cost and quality improvement.
- Subjects :
- Age Distribution
Comorbidity
Cost-Benefit Analysis
Florida epidemiology
Health Services Research
Humans
Likelihood Functions
Middle Aged
Pancreaticoduodenectomy economics
Pancreaticoduodenectomy mortality
Practice Patterns, Physicians' economics
Regression Analysis
Severity of Illness Index
Time Factors
Total Quality Management
Academic Medical Centers economics
Academic Medical Centers statistics & numerical data
Hospital Charges statistics & numerical data
Hospital Mortality
Length of Stay statistics & numerical data
Pancreatic Neoplasms economics
Pancreatic Neoplasms mortality
Pancreatic Neoplasms surgery
Pancreaticoduodenectomy statistics & numerical data
Practice Patterns, Physicians' statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1091-255X
- Volume :
- 5
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
- Publication Type :
- Academic Journal
- Accession number :
- 11309644
- Full Text :
- https://doi.org/10.1016/s1091-255x(01)80009-3