Evidence map›Paper›PMID 31831528›Full record

ArticleBMJ open2019

Can a simple 'cost-awareness' campaign for laparoscopic hysterectomy change the use and costs of disposable surgical supplies? Pre-post non-controlled study.

Sue Ross, Douglas Lier, Goldie Mackinnon, Christine Bentz, Gloria Rakowski, Valerie A Capstick

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
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

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Strategies for Cost Optimization in Minimally Invasive Gynecologic Surgery.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Review
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

6 authors at 2 institutions in 1 country.

Sue RossObstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada sjross@ualberta.ca.ORCID 0000-0002-0600-4833
Douglas LierObstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.
Goldie MackinnonObstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.
Christine BentzObstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.
Gloria RakowskiWomen's Health, Lois Hole Hospital for Women, Alberta Health Services, Edmonton, Alberta, Canada.
Valerie A CapstickObstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.
University of Alberta · CAAlberta Health Services · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDoes a cost-awareness campaign for gynaecologists lead to a change in use and costs of disposable surgical supplies for laparoscopic hysterectomy (LH) without increasing hospital utilisation measures (operating room (OR) time or hospital length of stay (LOS))?

designPre-post non-controlled study. The OR database was used to identify relevant cases before and after the cost-awareness intervention, and provided information on quantity of each supply item, operative details and LOS.

settingLois Hole Hospital for Women, Edmonton, Alberta, Canada.

participants12 laparoscopic trained gynaecologists (7 female, 5 male) participated in both phases of the study. Eligible surgical cases were all LH cases for any indication for women aged ≥18 years. 201 cases were undertaken before the intervention (2011-2013) and 229 cases after the intervention (2016-2017).

interventionThe cost-awareness intervention for gynaecologists included site meetings and rounds providing information on costs of disposable and reusable instruments, a full day skills lab, OR posters about cost and effectiveness of disposable and reusable surgical supplies and demonstrations of reusable equipment (2015-2016). PRIMARY OUTCOME MEASURE: Disposable supplies costs per case (standardised for 2016 unit costs).

resultsThere was a significant (p<0.05) reduction (unadjusted) in disposable supplies cost per case for LH between cases before and after the intervention: from $C1073, SD 281, to $C943 SD 209. Regression analysis found that the adjusted cost per case after the intervention was $C116 lower than before the intervention (95% CI -160 to -71). Neither OR time nor hospital LOS differed significantly between cohorts.

conclusionsOur study suggests that cost-awareness campaigns may be associated with reduction in the cost of surgery for LH. However, many other factors may have contributed to this cost reduction, possibly including other local initiatives to reduce costs and emerging evidence indicating lack of effectiveness of some surgical practices.

Indexed as

AdultAlbertaAttitude of Health PersonnelCost-Benefit AnalysisDisposable EquipmentEquipment and Supplies UtilizationEquipment ReuseFemaleGynecologyHumansHysterectomyLaparoscopyMiddle AgedOperating RoomsPractice Patterns, Physicians'Regression Analysiscost awarenessdisposable/reusable surgical supplieslaparoscopic hysterectomypre-post study

Identifiers

PMID31831528
PMCPMC6924870
OpenAlexW2996327665

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.