PMID- 28917016
OWN - NLM
STAT- MEDLINE
DCOM- 20191009
LR  - 20191010
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 32
IP  - 4
DP  - 2018 Apr
TI  - Predictors of outpatient resource utilization following ventral and incisional 
      hernia repair.
PG  - 1695-1700
LID - 10.1007/s00464-017-5849-6 [doi]
AB  - INTRODUCTION: Little is known about the predictors of increased ambulatory costs 
      following open ventral and incisional hernia repair (VIHR); however, 
      postoperative complications would be expected to be associated with an increased 
      burden on outpatient resources. The purpose of this study is to evaluate the 
      impact of perioperative factors on outpatient resource utilization following 
      VIHR. METHODS: With IRB approval, the surgery scheduling system was queried to 
      identify all cases of VIHR done at our institution over 3 years. Cases with other 
      procedures done at time of VIHR were excluded. National Surgical Quality 
      Improvement Program clinical data, physician billing data which included market 
      and payor across cases, and medical record review data were combined and 
      evaluated in order to quantify care and predictors of usage during the 6 months 
      postoperatively. RESULTS: Data were analyzed for 308 patients. Median patient age 
      was 52 years (SD = 13.3), and over half were female. The number of outpatient 
      visits to the surgical office varied from 0 to 18 [median = 2; interquartile 
      range (IQR) = 1-3]. CDC Wound Class >1 was associated with increase of mean 1.4 
      visits (IQR: 0.5-2.3); p = 0.003. Component separation, longer duration of 
      operation, and increased mesh size were also predictive of increased number of 
      office visits (p < 0.01). Postoperative infected seroma/seroma requiring drainage 
      added a mean 2.3 visits (IQR: 1.3-3.3), (p < 0.001); and deep wound infection 
      added a mean 3.9 visits (IQR: 1.9-5.9) (p < 0.001). CONCLUSIONS: Postoperative 
      complications confer a significant burden for patients and to the outpatient 
      surgical office. In an era in which improved quality and cost-efficiency has 
      become imperative, measures to decrease risk of postoperative complications 
      particularly for more complex VIHR would be expected to decrease resource 
      utilization and increase value of care.
FAU - Wade, Alex
AU  - Wade A
AD  - University of Kentucky College of Medicine, Lexington, KY, USA.
FAU - Plymale, Margaret A
AU  - Plymale MA
AD  - Division of General Surgery, Department of Surgery, University of Kentucky 
      College of Medicine, C 225, Chandler Medical Center, 800 Rose Street, Lexington, 
      KY, 40536, USA.
FAU - Davenport, Daniel L
AU  - Davenport DL
AD  - Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, 
      USA.
FAU - Johnson, Sara E
AU  - Johnson SE
AD  - University of Kentucky College of Medicine, Lexington, KY, USA.
FAU - Madabhushi, Vashisht V
AU  - Madabhushi VV
AD  - Division of General Surgery, Department of Surgery, University of Kentucky 
      College of Medicine, C 225, Chandler Medical Center, 800 Rose Street, Lexington, 
      KY, 40536, USA.
FAU - Mastoroudis, Erica
AU  - Mastoroudis E
AD  - Division of General Surgery, Department of Surgery, University of Kentucky 
      College of Medicine, C 225, Chandler Medical Center, 800 Rose Street, Lexington, 
      KY, 40536, USA.
FAU - Tancula, Charlie
AU  - Tancula C
AD  - Division of General Surgery, Department of Surgery, University of Kentucky 
      College of Medicine, C 225, Chandler Medical Center, 800 Rose Street, Lexington, 
      KY, 40536, USA.
FAU - Roth, John Scott
AU  - Roth JS
AD  - Division of General Surgery, Department of Surgery, University of Kentucky 
      College of Medicine, C 225, Chandler Medical Center, 800 Rose Street, Lexington, 
      KY, 40536, USA. s.roth@uky.edu.
LA  - eng
PT  - Journal Article
DEP - 20170915
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Health Resources
MH  - Hernia, Ventral/*surgery
MH  - *Herniorrhaphy/methods
MH  - Humans
MH  - Incisional Hernia/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Outpatients
MH  - Patient Acceptance of Health Care/*statistics & numerical data
MH  - Postoperative Complications/etiology/*surgery
OTO - NOTNLM
OT  - Ambulatory costs
OT  - Hospital costs
OT  - Outpatient resource utilization
OT  - Postoperative complications
OT  - Surgical site infection
OT  - Ventral hernia repair
EDAT- 2017/09/17 06:00
MHDA- 2019/10/11 06:00
CRDT- 2017/09/17 06:00
PHST- 2017/04/08 00:00 [received]
PHST- 2017/08/22 00:00 [accepted]
PHST- 2017/09/17 06:00 [pubmed]
PHST- 2019/10/11 06:00 [medline]
PHST- 2017/09/17 06:00 [entrez]
AID - 10.1007/s00464-017-5849-6 [pii]
AID - 10.1007/s00464-017-5849-6 [doi]
PST - ppublish
SO  - Surg Endosc. 2018 Apr;32(4):1695-1700. doi: 10.1007/s00464-017-5849-6. Epub 2017 
      Sep 15.