ArticleAnnals of surgical oncology2018
Drivers of Cost for Pancreatic Surgery: It's Not About Hospital Volume.
Article in Annals of surgical oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Association between volume and cost in low-resection volume regions: a population-level study on pancreatoduodenectomy for pancreatic cancer patients.ANZ journal of surgery · 2025Article
- Methods in regression analysis in surgical oncology research-best practice guidelines.Journal of surgical oncology · 2024Article
- Regionalization of pancreatic surgery in California: Benefits for preventing postoperative deaths and reducing healthcare costs.Surgery open science · 2023Article
- Data resources for evaluating the economic and financial consequences of surgical care in the United States.The journal of trauma and acute care surgery · 2022Review
- Is Improved Survival in Early-Stage Pancreatic Cancer Worth the Extra Cost at High-Volume Centers?Journal of the American College of Surgeons · 2021Article
- Risk factors and socio-economic burden in pancreatic ductal adenocarcinoma operation: a machine learning based analysis.BMC cancer · 2020Article
- Defining Value for Pancreatic Surgery in Early-Stage Pancreatic Cancer.JAMA surgery · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundOutcomes for pancreatic resection have been studied extensively due to the high morbidity and mortality rates, with high-volume centers achieving superior outcomes. Ongoing investigations include healthcare costs, given the national focus on reducing expenditures. Therefore, we sought to evaluate the relationships between pancreatic surgery costs with perioperative outcomes and volume status.
methodsWe performed a retrospective analysis of 27,653 patients who underwent elective pancreatic resections from October 2013 to June 2017 using the Vizient database. Costs were calculated from charges using cost-charge ratios and adjusted for geographic variation. Generalized linear modeling adjusting for demographic, clinical, and operation characteristics was performed to assess the relationships between cost and length of stay, complications, in-hospital mortality, readmissions, and hospital volume. High-volume centers were defined as hospitals performing ≥ 19 operations annually.
resultsThe unadjusted mean cost for pancreatic resection and corresponding hospitalization was $20,352. There were no differences in mean costs for pancreatectomies performed at high- and low-volume centers [- $1175, 95% confidence interval (CI) - $3254 to $904, p = 0.27]. In subgroup analysis comparing adjusted mean costs at high- and low-volume centers, there was no difference among patients without an adverse outcome (- $99, 95% CI - $1612 to 1414, p = 0.90), one or more adverse outcomes (- $1586, 95% CI - $4771 to 1599, p = 0.33), or one or more complications (- $2835, 95% CI - $7588 to 1919, p = 0.24).
conclusionsWhile high-volume hospitals have fewer adverse outcomes, there is no relationship between surgical volume and costs, which suggests that, in itself, surgical volume is not an indicator of improved healthcare efficiency reflected by lower costs. Patient referral to high-volume centers may not reduce overall healthcare expenditures for pancreatic operations.
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