Variation of outcome and charges in operative management for diverticulitis

Fuchs, Hans; Broderick, Ryan C.; Harnsberger, Cristina R.; Chang, David C.; McLemore, Elisabeth C.; Ramamoorthy, Sonia; Horgan, Santiago

doi:10.1007/s00464-014-4046-0

Cited by 10 publications

(17 citation statements)

References 29 publications

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“…The CCI is associated with an increase in AD-related mortality and recurrence rate. 28,29 Instead in our study, we found a progressive reduction of CCI score in the observed period, mainly in the uncomplicated form of diverticulitis. This could be explained by the reduction in the mean age of patients at admission.…”

Section: Discussioncontrasting

confidence: 63%

Increasing trend in admission rates and costs for acute diverticulitis during 2005–2015: real-life data from the Abruzzo Region

Cammarota¹,

Cargiolli

Andreozzi

et al. 2018

Therap Adv Gastroenterol

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Background:Scarce data are available on the epidemiological trend of diverticulitis and its financial burden in Italy. The aim of this work was to explore a potential variation in the rate and costs of hospital admissions for uncomplicated and complicated diverticulitis over the last decade.Methods:We selected all hospitalizations for diverticulitis of residents in the Abruzzo Region, Italy between 2005 and 2015. Age-standardized hospitalization rates (HRs) per 100,000 inhabitants for overall, uncomplicated and complicated diverticulitis were calculated. A linear model on the log of the age-standardized rates was used to calculate annual percentage changes (APC). Costs were derived from the official DRG tariff.Results:From 2005 to 2015, the HR for acute diverticulitis increased from 38.9 to 45.2 per 100,000 inhabitants (APC + 1.9%). The HR for complicated diverticulitis increased from 5.9 to 13.3 (APC + 7.6%), whereas it remained stable for uncomplicated diverticulitis. The mean hospital cost was 1.8-times higher for complicated diverticulitis compared with that for uncomplicated disease and 3.5-times higher for patients with a surgery stay compared with that for patients with a medical stay.Conclusion:During the last decade, in the Abruzzo Region, the HRs for diverticulitis and their costs increased significantly, mainly due to disease complications. Further studies are needed to explore strategies to prevent complications and to realise cost-saving policies.

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Section: Discussioncontrasting

confidence: 63%

Increasing trend in admission rates and costs for acute diverticulitis during 2005–2015: real-life data from the Abruzzo Region

Cammarota¹,

Cargiolli

Andreozzi

et al. 2018

Therap Adv Gastroenterol

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“…After being assessed for the availability of data for indigenous vs nonindigenous populations, 80 articles were subsequently removed. Following bibliography scans, contact with international experts, and gray literature search, an additional 9 articles and 7 reports were added, leaving a total of 21 articles [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]42,44 and 7 reports 14,[45][46][47][48][49][50] from 27 studies for data extraction.…”

Section: Resultsmentioning

confidence: 99%

“…Meta-data for all included studies are presented in Table 2. Of 21 articles, 11 studies were conducted in the US, [26][27][28][29]31,[35][36][37][38]42,51 7 in Australia, 25,30,33,34,39,40,44 and 2 in New Zealand. 32,43 All were cohort studies, with 17 retrospective studies 25,[28][29][30][31][32][33][35][36][37][38][39][41][42][43][44]51 and3prospective studies (from 4 articles).…”

Section: Study Characteristicsmentioning

confidence: 99%

Postoperative Mortality of Indigenous Populations Compared With Nonindigenous Populations

et al. 2020

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IMPORTANCEA range of factors have been identified as possible contributors to racial/ethnic differences in postoperative mortality that are also likely to hold true for indigenous populations. Yet despite its severity as an outcome, death in the period following a surgical procedure is underresearched for indigenous populations.OBJECTIVE To describe postoperative mortality experiences for minority indigenous populations compared with numerically dominant nonindigenous populations and examine the factors that drive any differences observed.EVIDENCE REVIEW This review was conducted according to PRIMSA guidelines and registered on PROSPERO. Articles were identified through searches of the Embase, Ovid MEDLINE, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases, with manual review of references and gray literature searches conducted. Eligible articles included those that reported associations between ethnicity/indigeneity and mortality up to 90 days following surgery and published in English between January 1, 1990, and March 26, 2019. Data on the study design, setting, participants (including indigeneity), and results were extracted. A modified Newcastle-Ottawa Quality Assessment Scale was used to determine study quality.FINDINGS A total of 442 abstracts were screened, 92 articles were reviewed in full text, and 21 articles (from 20 studies) and 7 reports underwent data extraction. All included studies were cohort studies (3 prospective and the remainder retrospective) investigating a wide range of surgical procedures in the US, Australia, or New Zealand. Seven studies were from single facilities, while the remainder used data from national databases. Sample sizes ranged, with indigenous sample sizes ranging from 20 to 3052 patients and a number of studies reporting less than 10 indigenous deaths. The postoperative mortality experience for minority indigenous populations compared with the nonindigenous populations was mixed. There was evidence from several studies that indigenous populations may be more likely to die following cardiac procedures. However, the available evidence has overall poor study quality, with methods to identify the indigenous populations being a major limitation of most of the studies. CONCLUSIONS AND RELEVANCEPostoperative mortality experiences for indigenous populations should not be interpreted in isolation from the broader context of inequities across the health care pathway and must take into account the quality of data used for indigenous identification.

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“…Outcome variation between regions, health networks and individual centres has been demonstrated internationally across many procedures, including pancreaticoduodenectomy (PD). A national USA study confirmed a significant geographical variation in mortality for patients undergoing surgical management of diverticulitis despite adjustment for demographic and socio‐economic factors . Furthermore, two USA studies investigating colonic resection for malignancy determined significant variation in risk standardized in‐hospital mortality rates across the nation .…”

Section: Introductionmentioning

confidence: 99%

“…A national USA study confirmed a significant geographical variation in mortality for patients undergoing surgical management of diverticulitis despite adjustment for demographic and socioeconomic factors. 2 Furthermore, two USA studies investigating colonic resection for malignancy determined significant variation in risk standardized in-hospital mortality rates across the nation. 9,10 Analysis demonstrated five hospital networks to have significantly higher risk adjusted 30-day post-operative mortality compared with others across England.…”

Section: Introductionmentioning

confidence: 99%

Regional versus metropolitan pancreaticoduodenectomy mortality in Australia

Davis

Babidge

Kiermeier³

et al. 2019

ANZ Journal of Surgery

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Background This retrospective, population‐based cohort study aims to determine if differences in the regional distribution of procedures or variation in regional mortality contributes to the variable pancreaticoduodenectomy (PD) mortality between Australian states and territories. Methods De‐identified procedural data from public hospitals between 1 July 2005 and 30 June 2015 from the Australian Institute of Health and Welfare were analysed. The regional distribution of procedures and variation in perioperative mortality rate (POMR) were investigated in New South Wales (NSW), Victoria and Queensland (QLD) using logistic regression analysis. Results NSW performed the highest proportion of city‐based procedures (93.8%) while QLD performed the highest proportion of regional procedures (15.3%). QLD demonstrated the lowest city mortality (1.9%) and lowest POMR overall (2.0%). City, regional and state‐wide mortality was highest in NSW (5.0%, 8.4% and 5.3%). No significant difference in POMR was demonstrated between regional and city hospitals in each of the states (P = 0.46) or across all states (P = 0.50). Conclusion This study demonstrates comparable regional PD distribution across Australia. The difference in PD POMR between city and regional areas was not found to be statistically significant. NSW exhibited the highest city, regional and overall PD POMR, potentially warranting further investigation.

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Variation of outcome and charges in operative management for diverticulitis

Cited by 10 publications

References 29 publications

Increasing trend in admission rates and costs for acute diverticulitis during 2005–2015: real-life data from the Abruzzo Region

Increasing trend in admission rates and costs for acute diverticulitis during 2005–2015: real-life data from the Abruzzo Region

Postoperative Mortality of Indigenous Populations Compared With Nonindigenous Populations

Regional versus metropolitan pancreaticoduodenectomy mortality in Australia

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