Evidence map›Paper›PMID 30579568›Full record

ArticleGynecologic oncology2019

Variation in resource utilization associated with the surgical management of ovarian cancer.

J Alejandro Rauh-Hain, Michael K Hidrue, Peter Gaccione, Alexander Melamed, Larissa A Meyer, Nancy L Keating, Sharon H Giordano, Laurel W Rice, Michael J Birrer, Marcela G Del Carmen

Abstract read
In one paragraph

Article in Gynecologic oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

J Alejandro Rauh-HainDepartment of Gynecologic Oncology and Reproductive Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA; Department of Health Services Research, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. Electronic address: jarauh@mdanderson.org.
Michael K HidrueMassachusetts General Physicians Organization, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Peter GaccioneDivision of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Alexander MelamedDivision of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Larissa A MeyerDepartment of Gynecologic Oncology and Reproductive Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA; Department of Health Services Research, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Nancy L KeatingDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA; Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Sharon H GiordanoDepartment of Health Services Research, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Laurel W RiceDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Michael J BirrerDepartment of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
Marcela G Del CarmenMassachusetts General Physicians Organization, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
Program in Cancer Research Outcomes Training (PCORT)R25CA092203 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI GAZELLE, G SCOTT · 2002 to 2016
$8.2M
Training in Oncology Population Sciences (TOPS)T32CA092203 · NCI · DANA-FARBER CANCER INST · PI Nancy L Keating, JENNIFER W MACK · 2018 to 2026
$3.7M
Obstetrical and Oncological Outcomes Among Reproductive Age Women with Gynecological and Breast CancerK08CA234333 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI RAUH-HAIN, JOSE ALEJANDRO · 2018 to 2022
$1.2M
NCI NIH HHS K08 CA234333NCI NIH HHS P30 CA016672NCI NIH HHS R25 CA092203NCI NIH HHS T32 CA092203
6 · The paper itself

Abstract

objectiveIdentify the major factors that drive standardized cost in providing surgical care for women with ovarian cancer, characterize the magnitude of variation in resource utilization between centers, and to investigate the relationship between resource utilization and quality of care provided.

methodsRetrospective cohort study of hospitals across the United States reporting to the Premier Database who cared for patients with ovarian cancer diagnosed between 2007 and 2014. The primary outcome was standardized total cost of the index hospitalization. To assess the relationship between hospital standardized costs and patient outcomes, we identified four measures of quality: 1) complications, 2) re-operation, 3) length of stay > 15 days, and 4) unplanned readmission.

resultsThe study population included 15,857 patients treated at 226 hospitals. The median standardized cost for hospitalizations was $13,267 (IQR = $3342). Reoperation was associated with 49% increase (95% CI = 43%-56%), and having minor complication was associated with 10% (95% CI = 8%-12%) increase in standardized cost, a moderate complication was associated with 36% (95% CI = 33%-38%) increase, and a major complication was associated with 83% (95% CI = 76%-89%) increase. The average risk-adjusted hospital standardized costs for hospitals in the highest resource use quartiles was 56% higher than the average hospital costs for hospitals in the lowest quartile ($10,826 vs. $16,933). The largest variation was in operating room standardized cost (45.5% of the total variation in operating room cost is explained by differences in hospital practices) and supplies (41.7%).

conclusionsWe identified significant variation in standardized costs among women who underwent surgery for ovarian cancer, operating room and supply costs are the largest drivers of variation.

Indexed as

FemaleHospital CostsHumansLaparoscopyMiddle AgedModels, EconomicOvarian NeoplasmsQuality of Health CareUnited StatesAssociation of surgical cost and patient outcomesOvarian cancerVariation in surgical cost

Identifiers

PMID30579568
PMCPMC6420848

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.