Impact of laparoscopic versus open surgery on hospital costs for colon cancer: a population-based retrospective cohort study

Mauro Laudicella, Brendan Walsh, Aruna Munasinghe, Omar Faiz

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: Laparoscopy is increasingly being used as an alternative to open surgery in the treatment of patients with colon cancer. The study objective is to estimate the difference in hospital costs between laparoscopic and open colon cancer surgery.

DESIGN: Population-based retrospective cohort study.

SETTINGS: All acute hospitals of the National Health System in England.

POPULATION: A total of 55 358 patients aged 30 and over with a primary diagnosis of colon cancer admitted for planned (elective) open or laparoscopic major resection between April 2006 and March 2013.

PRIMARY OUTCOMES: Inpatient hospital costs during index admission and after 30 and 90 days following the index admission.

RESULTS: Propensity score matching was used to create comparable exposed and control groups. The hospital cost of an index admission was estimated to be £1933 (95% CI 1834 to 2027; p<0.01) lower among patients who underwent laparoscopic resection. After including the first unplanned readmission following index admission, laparoscopy was £2107 (95% CI 2000 to 2215; p<0.01) less expensive at 30 days and £2202 (95% CI 2092 to 2316; p<0.01) less expensive at 90 days. The difference in cost was explained by shorter hospital stay and lower readmission rates in patients undergoing minimal access surgery. The use of laparoscopic colon cancer surgery increased 4-fold between 2006 and 2012 resulting in a total cost saving in excess of £29.3 million for the National Health Service (NHS).

CONCLUSIONS: Laparoscopy is associated with lower hospital costs than open surgery in elective patients with colon cancer suitable for both interventions.

OriginalsprogEngelsk
TidsskriftBMJ Open
Vol/bind6
Udgave nummer11
Sider (fra-til)e012977
ISSN2044-6055
DOI
StatusUdgivet - 3. nov. 2016
Udgivet eksterntJa

Fingeraftryk

Hospital Costs
Colonic Neoplasms
Cohort Studies
Retrospective Studies
Population
Propensity Score
National Health Programs
England
Inpatients
Length of Stay
Control Groups
Health

Bibliografisk note

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Citer dette

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title = "Impact of laparoscopic versus open surgery on hospital costs for colon cancer: a population-based retrospective cohort study",
abstract = "OBJECTIVE: Laparoscopy is increasingly being used as an alternative to open surgery in the treatment of patients with colon cancer. The study objective is to estimate the difference in hospital costs between laparoscopic and open colon cancer surgery.DESIGN: Population-based retrospective cohort study.SETTINGS: All acute hospitals of the National Health System in England.POPULATION: A total of 55 358 patients aged 30 and over with a primary diagnosis of colon cancer admitted for planned (elective) open or laparoscopic major resection between April 2006 and March 2013.PRIMARY OUTCOMES: Inpatient hospital costs during index admission and after 30 and 90 days following the index admission.RESULTS: Propensity score matching was used to create comparable exposed and control groups. The hospital cost of an index admission was estimated to be £1933 (95{\%} CI 1834 to 2027; p<0.01) lower among patients who underwent laparoscopic resection. After including the first unplanned readmission following index admission, laparoscopy was £2107 (95{\%} CI 2000 to 2215; p<0.01) less expensive at 30 days and £2202 (95{\%} CI 2092 to 2316; p<0.01) less expensive at 90 days. The difference in cost was explained by shorter hospital stay and lower readmission rates in patients undergoing minimal access surgery. The use of laparoscopic colon cancer surgery increased 4-fold between 2006 and 2012 resulting in a total cost saving in excess of £29.3 million for the National Health Service (NHS).CONCLUSIONS: Laparoscopy is associated with lower hospital costs than open surgery in elective patients with colon cancer suitable for both interventions.",
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Impact of laparoscopic versus open surgery on hospital costs for colon cancer : a population-based retrospective cohort study. / Laudicella, Mauro; Walsh, Brendan; Munasinghe, Aruna; Faiz, Omar.

I: BMJ Open, Bind 6, Nr. 11, 03.11.2016, s. e012977.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Impact of laparoscopic versus open surgery on hospital costs for colon cancer

T2 - a population-based retrospective cohort study

AU - Laudicella, Mauro

AU - Walsh, Brendan

AU - Munasinghe, Aruna

AU - Faiz, Omar

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PY - 2016/11/3

Y1 - 2016/11/3

N2 - OBJECTIVE: Laparoscopy is increasingly being used as an alternative to open surgery in the treatment of patients with colon cancer. The study objective is to estimate the difference in hospital costs between laparoscopic and open colon cancer surgery.DESIGN: Population-based retrospective cohort study.SETTINGS: All acute hospitals of the National Health System in England.POPULATION: A total of 55 358 patients aged 30 and over with a primary diagnosis of colon cancer admitted for planned (elective) open or laparoscopic major resection between April 2006 and March 2013.PRIMARY OUTCOMES: Inpatient hospital costs during index admission and after 30 and 90 days following the index admission.RESULTS: Propensity score matching was used to create comparable exposed and control groups. The hospital cost of an index admission was estimated to be £1933 (95% CI 1834 to 2027; p<0.01) lower among patients who underwent laparoscopic resection. After including the first unplanned readmission following index admission, laparoscopy was £2107 (95% CI 2000 to 2215; p<0.01) less expensive at 30 days and £2202 (95% CI 2092 to 2316; p<0.01) less expensive at 90 days. The difference in cost was explained by shorter hospital stay and lower readmission rates in patients undergoing minimal access surgery. The use of laparoscopic colon cancer surgery increased 4-fold between 2006 and 2012 resulting in a total cost saving in excess of £29.3 million for the National Health Service (NHS).CONCLUSIONS: Laparoscopy is associated with lower hospital costs than open surgery in elective patients with colon cancer suitable for both interventions.

AB - OBJECTIVE: Laparoscopy is increasingly being used as an alternative to open surgery in the treatment of patients with colon cancer. The study objective is to estimate the difference in hospital costs between laparoscopic and open colon cancer surgery.DESIGN: Population-based retrospective cohort study.SETTINGS: All acute hospitals of the National Health System in England.POPULATION: A total of 55 358 patients aged 30 and over with a primary diagnosis of colon cancer admitted for planned (elective) open or laparoscopic major resection between April 2006 and March 2013.PRIMARY OUTCOMES: Inpatient hospital costs during index admission and after 30 and 90 days following the index admission.RESULTS: Propensity score matching was used to create comparable exposed and control groups. The hospital cost of an index admission was estimated to be £1933 (95% CI 1834 to 2027; p<0.01) lower among patients who underwent laparoscopic resection. After including the first unplanned readmission following index admission, laparoscopy was £2107 (95% CI 2000 to 2215; p<0.01) less expensive at 30 days and £2202 (95% CI 2092 to 2316; p<0.01) less expensive at 90 days. The difference in cost was explained by shorter hospital stay and lower readmission rates in patients undergoing minimal access surgery. The use of laparoscopic colon cancer surgery increased 4-fold between 2006 and 2012 resulting in a total cost saving in excess of £29.3 million for the National Health Service (NHS).CONCLUSIONS: Laparoscopy is associated with lower hospital costs than open surgery in elective patients with colon cancer suitable for both interventions.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Colectomy/economics

KW - Colonic Neoplasms/economics

KW - Elective Surgical Procedures

KW - England

KW - Female

KW - Hospital Costs

KW - Hospitalization/economics

KW - Hospitals

KW - Humans

KW - Laparoscopy/economics

KW - Length of Stay/economics

KW - Male

KW - Middle Aged

KW - Patient Readmission/economics

KW - Propensity Score

KW - Retrospective Studies

U2 - 10.1136/bmjopen-2016-012977

DO - 10.1136/bmjopen-2016-012977

M3 - Journal article

C2 - 27810978

VL - 6

SP - e012977

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 11

ER -