Journal article
Surgeon volume impact on outcomes and cost of adrenal surgeries
European journal of surgical oncology, Vol.42(10), pp.1483-1490
10/01/2016
DOI: 10.1016/j.ejso.2016.06.392
PMID: 27378161
Abstract
The number of adrenal surgeries performed in the United Stated is continuing to increase. Identifying factors associated with favorable outcomes can have a major impact on cost-differences. We aim to assess the impact of surgeon volume on both clinical outcomes and cost following adrenal surgery.
A cross-sectional analysis was performed utilizing data from the Nationwide Inpatient Sample, 2003–2009. Surgeon volumes included (adrenalectomies/year): low-volume (1), intermediate-volume (2–6), and high-volume (≥7).
A total of 7045 patients were included. Surgeries performed by low-volume surgeons were associated with a higher risk of postoperative complications [OR: 1.66, 95% CI: (1.23, 2.24)]. During the study period, if all operations performed by low-volume surgeons were selectively referred to intermediate-volume surgeons, a 7.7% cost savings would have been incurred. Potential savings were even higher (8.1%) if the operations had been performed by the high-volume surgeons. With the conservative assumption that there are 5000 adrenalectomies per year in the United States, the high-volume surgeons would produce savings of $8.8 million over a span of 14 years.
A surgeon's expertise is associated with favorable outcomes. Our model estimates that considerable cost savings are attainable with appropriate referrals to high volume endocrine surgeons.
Details
- Title: Subtitle
- Surgeon volume impact on outcomes and cost of adrenal surgeries
- Creators
- Z. Al-Qurayshi - Tulane UniversityR. Robins - Tulane UniversityJ. Buell - Tulane UniversityE. Kandil - Tulane University
- Resource Type
- Journal article
- Publication Details
- European journal of surgical oncology, Vol.42(10), pp.1483-1490
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.ejso.2016.06.392
- PMID
- 27378161
- ISSN
- 0748-7983
- eISSN
- 1532-2157
- Number of pages
- 8
- Language
- English
- Date published
- 10/01/2016
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702941802771
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