Economic Consequences of Surgery for Adhesive Small Bowel Obstruction: A Population-Based Study.

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Thorbjörn Sakari, Sophie Langenskiöld, Filip Sköldberg, Urban Karlbom
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Abstract

Background and aims: Most patients develop adhesions after abdominal surgery, some will be hospitalized with small bowel obstruction (SBO), and some also require surgery. The operations and follow-up are expensive, but recent data of costs are scarce. The aim of this study was to describe the direct costs of SBO-surgery and follow-up, in a population-based setting. The association between cost of SBO and peri- and postoperative data was also studied.

Methods: In a retrospective cohort study, all patients (n = 402) operated for adhesive SBO in Gävleborg and Uppsala counties (2007-2012) were studied. The median follow-up was 8 years. Costs were calculated according to the pricelist of Uppsala University Hospital, Uppsala, Sweden.

Results: Overall total costs were €16.267 million, corresponding to a mean total cost per patient of €40,467 during the studied period. Diffuse adhesions and postoperative complications were associated with increased costs for SBO in a multivariable analysis (P < 0.001). Most costs, about €14 million (85%), arouse in conjunction with the SBO-index surgery period. In-hospital stay was the dominating cost, accounting for 70% of the total costs.

Conclusion: Surgery for SBO generates substantial economic burden for healthcare systems. Measures that reduce the incidence of SBO, the frequency of postoperative complication, or the length of stay have the potential to reduce this economic burden. The cost estimates from this study may be valuable for future cost-benefit analyses in intervention studies.

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Abstract Image

粘连性小肠梗阻手术的经济后果:一项基于人群的研究。
背景与目的:大多数患者在腹部手术后出现粘连,部分患者会因小肠梗阻(SBO)住院,部分患者还需要手术治疗。手术和随访费用昂贵,但最近的费用数据很少。本研究的目的是描述以人群为基础的sbo手术和随访的直接成本。SBO成本与围手术期和术后数据之间的关系也被研究。方法:回顾性队列研究,对2007-2012年在Gävleborg和乌普萨拉县(Uppsala county)接受黏附性SBO手术的所有患者(n = 402)进行研究。中位随访时间为8年。根据瑞典乌普萨拉乌普萨拉大学医院的价目表计算费用。结果:总体总成本为1626.7万欧元,相当于研究期间每位患者的平均总成本为40467欧元。在多变量分析中,弥漫性粘连和术后并发症与SBO的成本增加相关(P < 0.001)。大多数费用,约1400万欧元(85%),与sbo指数手术期有关。住院是主要成本,占总成本的70%。结论:SBO手术给医疗系统带来了巨大的经济负担。减少SBO发生率、术后并发症频率或住院时间的措施有可能减轻这一经济负担。本研究的成本估计可能对未来干预研究的成本效益分析有价值。
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来源期刊
Gastroenterology Research and Practice
Gastroenterology Research and Practice GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
0.00%
发文量
91
审稿时长
1 months
期刊介绍: Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders. Topics of interest include: Management of pancreatic diseases Third space endoscopy Endoscopic resection Therapeutic endoscopy Therapeutic endosonography.
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