Use
of minimally invasive surgery could lower health care costs by hundreds of
millions a year
Johns Hopkins Medicine, Science
Daily
A new analysis of surgical outcomes nationwide concludes that
more use of minimally invasive surgery for certain common procedures can
dramatically reduce post-operative complications and shave hundreds of millions
of dollars off the nation's health care bill.
Results of the research, conducted by Johns Hopkins
investigators and published March 25 in JAMA-Surgery, indicate that
American hospitals collectively could prevent thousands of post-surgical
complications and save between $280 million and $340 million a year by using
more minimally invasive procedures instead of traditional open surgery for
routine operations of the appendix, colon and lungs.
Minimally invasive surgery, also known as laparoscopic or
keyhole surgery, involves making tiny surgical incisions, or
"keyholes," to access organs and operate on them, in contrast with
cutting into and through much larger areas of tissue.
For the study, the research team analyzed more than 80,000
surgical cases from the National Inpatient Sample database, tracking seven
common post-surgical complications and associated billing charges for certain
common operations.
The procedures tracked involved operations of the appendix,
colon or lungs, selected because both the traditional open and the minimally
invasive approaches are considered standard of care.
While not all patients are candidates for minimally invasive
treatment, the researchers note, the study revealed great variation in its use
among those who do qualify -- similar patients treated at similar hospitals.
To calculate the cost difference between traditional open and
minimally invasive surgery, the investigators compared the actual cost for each
patient who underwent traditional surgery against the estimated cost for the
same patient undergoing minimally invasive treatment.
In addition, the
investigators calculated potential cost savings under two hypothetical
scenarios: when all hospitals increased their use of minimally invasive surgery
by 50 percent and when the hospitals performing the fewest such procedures, the
so-called low utilizers, upped them to the level of hospitals performing in the
upper one-third.
The tally showed that if all U.S. hospitals increased the number
of minimally invasive procedures by 50 percent, they would avert 3,578
complications, reduce hospital stay by 144, 863 days and save $288 million a
year.
If hospitals performing the fewest minimally invasive operations boosted
their levels to those of their higher-performing counterparts, the collective
savings would be $337 million a year, 4,306 fewer complications and 169,819
fewer hospital days.
The research team says the findings should be heeded as a call
to action by hospital leaders to increase capacity for minimally invasive
treatment and create a more streamlined division of labor so that surgeons with
expertise in minimally invasive treatment can operate on patients who qualify
for this approach.
The authors caution that minimally invasive surgery is not
always the optimal method of treatment, and some patients are not candidates
for it.
"The decision to perform an open versus minimally invasive
procedure should be made according to each patient's specific case and overall
health, among other factors," Makary says. "But our results make a
very strong case that minimally invasive surgery is grossly underutilized and,
at a minimum, ought to be offered to patients more often."
Story Source:
The above story is based on materials provided by Johns Hopkins Medicine. Note:
Materials may be edited for content and length.
Journal Reference:
Martin A. Makary, MD, MPH et al. Hospital Cost Implications
of Increased Use of Minimally Invasive Surgery. JAMA Surgery, March
2015 DOI:10.1001/jamasurg.2014.4052
Cite This Page:
Johns Hopkins Medicine. "Use of minimally invasive surgery
could lower health care costs by hundreds of millions a year." Science Daily,
25 March 2015. <www.sciencedaily.com/releases/2015/03/150325110624.htm>.