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Title: Health costs of post-operative complications following rectal resection: a systematic review.
Austin Authors: Johnston, Samuel;Louis, Maleck ;Churilov, Leonid ;Ma, Ronald ;Christophi, Christopher ;Weinberg, Laurence 
Affiliation: Department of Finance, Austin Health, Heidelberg, Victoria, Australia
Melbourne Brain Centre, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Jul-2020
Date: 2020-02-13
Publication information: ANZ Journal of Surgery 2020; 90(7-8): 1270-1276
Abstract: Post-operative complications following rectal resection pose significant health and cost implications for patients and health providers. The objective of this study is to review the associated cost of complications following rectal resection. This included reporting on the proportion and severity of these complications, associated length of stay and surgical technique used. Studies were sourced from Embase OVID, MEDLINE OVID (ALL) and Cochrane Library databases by utilizing a search strategy. This search contained studies from 1 January 2010 until 13 February 2019. Studies were included from the year 2010 to account for the implementation of enhanced recovery after surgery protocols. Studies that reported the financial cost associated with complications were included. Any indication for rectal resection was considered. Data was extracted into a formatted table and a narrative synthesis was performed. We identified 13 eligible studies for inclusion. There was strong evidence to suggest that complications are associated with increased costs. There was considerable variation as to the costs attributable to complications ($1443 (P < 0.001) to $17 831 (P < 0.0012), n = 12). The presence of complications was associated with an increased length of stay (5.54 (P-value not given) to 21.04 (P < 0.0001) days, n = 7). There was significant variation in the proportion of complications (6.41 to 64.71%, n = 8). Weak evidence existed around surgical technique used and the associated cost of complications. There was considerable heterogeneity among included studies. Complications following rectal resection increased health costs. Costs should be standardized and provide a clear methodology for their calculation. Complications should be standardized and include a grading of severity.
DOI: 10.1111/ans.15708
ORCID: 0000-0002-1352-4255
Journal: ANZ Journal of Surgery
PubMed URL: 32053858
Type: Journal Article
Subjects: complication
cost analysis
Appears in Collections:Journal articles

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