Pricing of surgeries for colon cancer: patient severity and market factors.

摘要: BACKGROUND: This study examined effects of health maintenance organization (HMO) penetration, hospital competition, and patient severity on the uptake laparoscopic colectomy its price relative to open surgery for colon cancer. METHODS: The MarketScan Database (data from 2002-2007) was used identify admissions privately insured colorectal cancer patients undergoing or partial (n ¼ 1035 n 6389, respectively). Patient plan characteristics were retrieved these data; HMO market penetration rates an index concentration, Herfindahl-Hirschman (HHI), derived national databases. Logistic logarithmic regressions examine odds having colectomy, effect covariates prices, differential laparoscopy. RESULTS: Adoption laparoscopy highly sensitive forces, with a 10% increase in leading 10.9% likelihood (adjusted ratio 1.109; 95% confidence interval [CI] 1.062, 1.158) HHI resulting 6.6% lower 0.936; CI 0.880, 0.996). Price models indicated that 7.6% than (transformed coefficient 0.927; 0.895, 0.960). A associated 1.6% 0.985; 0.977, 0.992), whereas higher 1.016; 1.006, 1.027; P < .001 all comparisons). CONCLUSIONS: Laparoscopy significantly prices. Moreover, may result cost savings, while pressures contribute adoption. Cancer 2012;118:5741-8. V C 2012 American Society.