Costs of hepato-pancreato-biliary surgery and readmissions in privately insured US patients

• Published in: The Journal of surgical research 2015-12, Vol.199 (2), p.478-486
• Main Authors: Kulaylat, Afif N., MD, Schubart, Jane R., PhD, Schaefer, Eric W., MS, Hollenbeak, Christopher S., PhD, Cooper, Amanda B., MD, Gusani, Niraj J., MD, MS
• Format: Article
• Language: English
• Subjects: Adult; Costs; Economic; Female; Hepatectomy; Hepatectomy - economics; Humans; Insurance; Male; MarketScan; Middle Aged; Pancreatectomy; Pancreatectomy - economics; Patient Readmission - economics; Readmission; Surgery; United States; Young Adult
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2015.05.002

Abstract Background Surgical costs are influenced by perioperative care, readmissions, and further therapies. We aimed to characterize costs in hepato-pancreato-biliary surgery in the United States. Methods The MarketScan database (2008–2010) was used to identify privately insured patients undergoing pancreatectomy ( n  = 2254) or hepatectomy ( n  = 1702). Costs associated with the index surgery, readmissions, and total short-term costs were assessed from a third party payer perspective using generalized linear regression models. Results Mean total costs of pancreatectomy and hepatectomy were $107,600 (95% confidence interval [CI], 101,200–114,000) and $81,300 (95% CI, 77,600–85,000), respectively, with corresponding surgical costs of 69.2% and 60.9%. Ninety-day readmission costs were $36,200 (95% CI, 32,000–40,400) and $34,100 (95% CI, 28,100–40,100), respectively. In multivariate analysis, readmissions were associated with an almost two-fold increase in total costs in both pancreatectomy (cost ratio = 1.98; P