Hospital costs associated with adverse events in gynecological oncology

Kondalsamy-Chennakesavan, Srinivas, Gordon, Louisa G., Sanday, Karen, Bouman, Chantal, De Jong, Suzanne, Nicklin, James, Land, Russell and Obermair, Andreas (2011) Hospital costs associated with adverse events in gynecological oncology. Gynecologic Oncology, 121 1: 70-75. doi:10.1016/j.ygyno.2010.11.030


Author Kondalsamy-Chennakesavan, Srinivas
Gordon, Louisa G.
Sanday, Karen
Bouman, Chantal
De Jong, Suzanne
Nicklin, James
Land, Russell
Obermair, Andreas
Title Hospital costs associated with adverse events in gynecological oncology
Journal name Gynecologic Oncology   Check publisher's open access policy
ISSN 0090-8258
Publication date 2011-04
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.ygyno.2010.11.030
Volume 121
Issue 1
Start page 70
End page 75
Total pages 6
Place of publication United States
Publisher Academic Press
Collection year 2011
Language eng
Formatted abstract
Background and objective:
Treatment for gynecological malignancies is complex and may cause unintended or accidental adverse events (AE). We evaluated the costs of hospitalization associated with those AEs among patients who had an abdominal or laparoscopic procedure for proven or suspected gynecological cancer at a tertiary gynecological cancer center in Australia.

Methods:
Data on AEs were prospectively collected and matched with cost data (AU$ 2008) from the hospital's clinical costing unit and linked to demographical, clinical and histopathological data. Total costs were adjusted for various clinical factors and estimated using log-transformed ordinary least squared regression. Back-transformation was achieved using smearing factors. From epidemiological data, we also estimated the costs of AEs Australia-wide and undertook scenario and probabilistic sensitivity analyses to investigate the potential cost impact of reducing AEs.

Results:
A total of 369 patients had surgical procedures of which 95 patients (26%) had at least one AE. Patients with AEs incurred an extra AU$12,780 on average, adjusted for age, co-morbidities, ovarian cancer, major or minor complications, surgical complexity, presence of malignancy and abdominal surgery. Mean adjusted costs (95% CI) for patients with intra-operative, minor post-operative and major post-operative AEs were AU$40,746 (11,582-71,859) AU$18,459 (17,270-19,713) and AU$67,656 (5324-131,761), respectively. Up to an estimated AU$20.6 million/year could be saved if the AEs were reduced by 40%.

Conclusion:
Adverse events are associated with significantly increased hospitalization costs and appropriate evidence-based interventions are justified to minimize AEs. © 2010 Elsevier Inc.
Keyword Complications
Cost
Hospitalization
Laparoscopy
Laparotomy
Quality of surgical care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Thu, 17 Mar 2011, 12:31:25 EST by Dr Andreas Obermair on behalf of Obstetrics & Gynaecology - RBWH