Publications

print share
Version HistoryVersion History

Title

Variation in Intraoperative and Postoperative Utilization for 3 Common General Surgery Procedures (Annals of Surgery)

Publication Topics

Cost and Utilization Studies

Publication Type

Journal Article

Publication Date

2019-08-23T07:00:00Z

Author 1

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1463&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1463&RootFolder=*">Christopher P. Childers</a>

Author 2

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=287&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=287&RootFolder=*">Susan L. Ettner, PhD</a>

Author 3

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=144&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=144&RootFolder=*">Gerald F. Kominski, PhD</a>

Author 4

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=151&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=151&RootFolder=*">et al</a>

Author 5

Author 6

Author 7

Author 8

Author 9

Author 10

Author 11

Author 12

Author 13

Author 14

Abstract

​The aim of this study was to understand variation in intraoperative and postoperative utilization for common general surgery procedures. Authors used retrospective analysis of electronic health record data for 7,762 operations from two health systems. Adult patients undergoing laparoscopic cholecystectomy, appendectomy, and inguinal/femoral hernia repair between November 1, 2013 and November 30, 2017 were reviewed for three utilization measures: intraoperative disposable supply costs, procedure time, and postoperative length of stay (LOS). Crossed hierarchical regression models were fit to understand case-mixed adjusted variation in utilization across surgeons and locations and to rank surgeons.

The number of surgeons performing each type of operation ranged from 20 to 63. The variation explained by surgeons ranged from 8.9% to 38.2% for supply costs, from 15.1% to 54.6% for procedure time, and from 1.3% to 7.0% for postoperative LOS. The variation explained by location ranged from 12.1% to 26.3% for supply costs, from 0.2% to 2.5% for procedure time, and from 0.0% to 31.8% for postoperative LOS. There was a positive correlation between surgeons' higher supply costs and longer procedure times for hernia repair, but there was no correlation between other utilization measures for hernia repair and no correlation between any of the utilization measures for laparoscopic appendectomy or cholecystectomy.

Authors conclude that surgeons are significant drivers of variation in surgical supply costs and procedure time, but much less so for postoperative LOS. Intraoperative and postoperative utilization profiles can be generated for individual surgeons and may be an important tool for reducing surgical costs.

Thumbnail

Article 1

Journal Article: Variation in Intraoperative and Postoperative Utilization for 3 Common General Surgery Procedures

Article 2

Article 3

Article 4

Article 5

Article 6

Article 7

Article 8

Article 9

Article 10

Article 11

Article 12

Press Release

Related Link 1

Related Link 2

Related Link 3

Related Link 4

Related Link 5

Related Link 6

Related Link 7

Related Link 8

Related Link 9

Related Link 10

Related Link 11

Related Link 12

Related Link 13

Related Link 14

Related Link 15

Related Link 16

Version: 3.0
Created at 9/10/2019 11:30 AM by i:0#.f|uclachissqlmembershipprovider|bhan
Last modified at 9/12/2019 3:06 PM by i:0#.f|uclachissqlmembershipprovider|celeste