Abstract
BACKGROUND: Postoperative complications are a significant source of morbidity and mortality. There are limited studies, however, assessing the impact of common postoperative complications on health care resource utilization.
OBJECTIVE: To assess the association of clinically important postoperative complications with total hospital costs and length of stay (LOS) in patients undergoing noncardiac surgery.
METHODS: We determined total hospital costs and LOS in all patients admitted to a single tertiary care center between July 1, 1996 and March 31, 1998 using a detailed administrative hospital discharge database. Total hospital costs and LOS were adjusted for preoperative and surgical characteristics.
RESULTS: Of 7,457 patients who underwent noncardiac surgery, 6.9% developed at least 1 of the postoperative complications. These complications increased hospital costs by 78% (95% confidence interval [CI]: 68% to 90%) and LOS by 114% (95% CI: 100% to 130%) after adjustment for patient preoperative and surgical characteristics. Postoperative pneumonia was the most common complication (3%) and was associated with a 55% increase in hospital costs (95% CI: 42% to 69%) and an 89% increase in LOS (95% CI: 70% to 109%).
CONCLUSIONS: Postoperative complications consume considerable health care resources. Initiatives targeting prevention of these events could significantly reduce overall costs of care and improve patient quality of care.
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The authors have no conflicts of interest to declare for this paper.
Dr. Khan is funded by Canadian Institutes of Health Research (CIHR) and Michael Smith Foundation for Health Research postdoctoral fellowship awards. Dr. Khan also received postdoctoral fellowship funding from the Alberta Heritage Foundation for Medical Research (AHFMR) during the analysis of this data. Dr. Ghali is funded by AHFMR as a Scholar and holds a Canada Research Chair. Dr. Hude Quan is funded by CIHR as New Investigator and AHFMR as a Population Health Investigator.
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Khan, N.A., Quan, H., Bugar, J.M. et al. Association of postoperative complications with hospital costs and length of stay in a tertiary care center. J Gen Intern Med 21, 177–180 (2006). https://doi.org/10.1007/s11606-006-0254-1
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DOI: https://doi.org/10.1007/s11606-006-0254-1