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Five Years of Video Assisted Thoracoscopic Surgery (VATS) at an Academic Institution: a Retrospective Review of Cost and Complications
*Sarah Lomas, Bruce J Leavitt, Mitchell C. Norotsky
Fletcher Allen Health Care, University of Vermont, Burlington, VT
Main Outcome Measures:
American Society of Anesthesiologists (ASA) rating
Of the 319 patients identified, 24 suffered complications, the most common being prolonged air leak (n=11). The median total cost for patients without complications was $9,544, whereas the median total cost for patients with complications was 60% higher at $15,283 (Wilcoxon rank-sum test, p=0.002). There were no significant differences between ASA rating or age and presence of complications.
Howington et. al. found that VATS resulted in decreased operative times and hospital costs, and that the average cost of a VATS was $14,795 ± $4,415, which is similar to the range we found at our institution. We have shown how the added expense of a complication drives the cost toward the higher end of that range. As payments shift away from fee-for-service to flat fees based on admission diagnosis or procedure performed, the presence of a complication detracts from the bottom line. It is our duty to deliver quality care in the most cost effective manner possible.
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