Original articleGeneral thoracicWhat Is the Inpatient Cost of Hospital Complications or Death After Lobectomy or Pneumonectomy?
Section snippets
Clinical Data
Since 2004, the Providence Thoracic Surgery Program (TSP) has functioned within a large health system not affiliated with a university involving competing private practice surgical groups in two tertiary-care hospitals in a major metropolitan area (Providence Health and Services, Portland, OR). All surgeons performing any amount of thoracic surgery within general or cardiothoracic surgery groups and participating in multidisciplinary care are members of the TSP. A dedicated TSP data manager
Results
During 33 months, 294 anatomic resections were performed consisting of 268 lobectomies (lobectomy 229, sleeve 8, bilobectomy 20, segmentectomy 11) and 26 pneumonectomies (standard 13, carinal 1, completion 3, extrapleural 4, intrapericardial 5). Cardiothoracic surgeons performed 244 lobectomies and 24 pneumonectomies, and general surgeons performed 24 lobectomies and 2 pneumonectomies.
Table 1 displays common clinical characteristics contributing to thoracic surgery mortality risk [7, 8] for the
Comment
Cost of medical care has long been subjected to scrutiny with attempts to understand the components and drivers, thus enabling potential control of costs [1]. Most reports on cost of surgical care are actually based on charge data variously manipulated to derive cost inference [3, 9, 10].
The potential drivers of cost differences are complex. Do costs reflect more complex care as a result of patient characteristics (our lobectomy patients experiencing complications or death were older with worse
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