Assessment of health care cost for complex surgical patients: review of cost, re-imbursement and revenue involved in pancreatic surgery at a high-volume academic medical centre.

摘要: Abstract Background Pancreatic surgery is complex with the potential for costly hospitalization. Methods A retrospective review of patients undergoing a pancreatic resection was performed. Results The median age study population 64 years. Half cohort female (51%), and majority were white (62%). Most underwent pancreaticoduodenectomy (PD) (69%). pre-operative age-adjusted Charlson comorbidity index zero 36% ( n = 50), 1 31% 43) ≥2 33% 45). Clavien–Dindo grading system post-operative complication grade I in 17% 24), whereas 45% 62) higher grades. medians direct fixed, variable, fixed indirect total costs $2476, $15 397, $13 207 $31 631, respectively. There positive contribution margin $7108, net loss $6790. On univariate analyses, age, type operation associated cost P ≤ 0.05), 0.01). These findings remained significant on multivariate analysis Conclusions Increased cost, reimbursement revenue complications.