Comparison of the Clinical and Economic Outcomes Between Open and Minimally Invasive Appendectomy and Colectomy: Evidence from a Large Commercial Payer Database

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Comparison of the Clinical and Economic Outcomes Between Open and Minimally Invasive Appendectomy and Colectomy: Evidence from a Large Commercial Payer Database

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dc.contributor.author Fullum, Terrence M.
dc.contributor.author Borah, Bijan J.
dc.contributor.author Gunnarsson, Candace L.
dc.contributor.author Ladapo, Joseph Abiodun
dc.date.accessioned 2011-02-07T17:00:48Z
dc.date.issued 2009
dc.identifier.citation Fullum, Terrence M., Joseph A. Ladapo, Bijan J. Borah, and Candace L. Gunnarsson. 2009. Comparison of the clinical and economic outcomes between open and minimally invasive appendectomy and colectomy: evidence from a large commercial payer database. Surgical Endoscopy 24(4): 845-853. en_US
dc.identifier.issn 0930-2794 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:4706325
dc.description.abstract Background: Appendectomy and colectomy are commonly performed surgical procedures. Despite evidence demonstrating advantages with the minimally invasive surgical (MIS) approach, open procedures occur with greater prevalence. Therefore, there is still controversy as to whether the MIS approach is safer or more cost effective. Methods: A retrospective analysis was performed using a large commercial payer database. The data included information on 7,532 appendectomies and 2,745 colectomies. Data on the distribution of patient demographic and comorbidity characteristics associated with the MIS and open approaches were reviewed. The corresponding complication rates and expenditures were analyzed. Summary statistics were compared using chi-square tests, and generalized linear models were constructed to estimate expenditures while controlling for patient characteristics. Results: The patients undergoing MIS and open colectomy showed no significant variations in age distribution or marginal age differences for appendectomy. Significantly more patients experienced an infection postoperatively, and procedure-specific complications were more common in the open group for both procedures (P < 0.05). The postsurgical hospital stay was longer for the patients treated using the open techniques, differing an average of half a day for appendectomies and significantly more (4 days) for colectomy (P < 0.05). Readmission rates differed little between the two approaches. Procedures performed through an MIS approach were associated with lower expenditures than for the open technique, with differences ranging from $700 for appendectomy patients (P < 0.05) to $15,200 for colectomy patients (P < 0.05). Conclusions: Minimally invasive appendectomy and colectomy were associated with lower infection rates, fewer complications, shorter hospital stays, and lower expenditures than open surgery. en_US
dc.language.iso en_US en_US
dc.publisher Springer-Verlag en_US
dc.relation.isversionof doi:10.1007/s00464-009-0675-0 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846276/pdf/ en_US
dash.license LAA
dc.subject abdominal en_US
dc.subject minimally invasive en_US
dc.subject economic outcomes en_US
dc.subject appendectomy en_US
dc.subject colectomy en_US
dc.subject minimally invasive surgery (MIS) en_US
dc.subject open procedure en_US
dc.title Comparison of the Clinical and Economic Outcomes Between Open and Minimally Invasive Appendectomy and Colectomy: Evidence from a Large Commercial Payer Database en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal Surgical Endoscopy en_US
dash.depositing.author Ladapo, Joseph Abiodun
dc.date.available 2011-02-07T17:00:48Z
dash.affiliation.other HMS^Medicine- Beth Israel-Deaconess en_US
dash.affiliation.other HMS^Stipendees - MD-PhD en_US

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