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HOSPITAL VOLUME, POSTOPERATIVE MORTALITY, AND COSTS AFTER GASTRECTOMY FOR GASTRIC CANCER IN COLOMBIA: IS THERE ANY ASSOCIATION?

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Date 2023 Jul 12
PMID 37436278
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Abstract

Background: There are no information in the literature associating the volume of gastrectomies with survival and costs for the health system in the treatment of patients with gastric cancer in Colombia.

Aims: The aim of this study was to analyze how gastrectomy for gastric cancer is associated with hospital volume, 30-day and 180-day postoperative mortality, and healthcare costs in Bogotá, Colombia.

Methods: A retrospective cohort study based on hospital data of all adult patients with gastric cancer who underwent gastrectomy between 2014 and 2016 using a paired propensity score. The surgical volume was identified as the average annual number of gastrectomies performed by the hospital.

Results: A total of 743 patients were included in the study. Hospital mortality at 30 and 180 days postoperatively was 36 (4.85%) and 127 (17.09%) patients, respectively. The average health care cost was USD 3,200. A total of 26 or more surgeries were determined to be the high surgical volume cutoff. Patients operated on in hospitals with a high surgical volume had lower 6-month mortality (HR 0.44; 95%CI 0.27-0.71; p=0.001), and no differences were found in health costs (mean difference 398.38; 95%CI-418.93-1,215.69; p=0.339).

Conclusions: This study concluded that in Bogotá (Colombia), surgery in a high-volume hospital is associated with better 6-month survival and no additional costs to the health system.

References
1.
Smith J, McPhee J, Hill J, Whalen G, Sullivan M, Litwin D . National outcomes after gastric resection for neoplasm. Arch Surg. 2007; 142(4):387-93. DOI: 10.1001/archsurg.142.4.387. View

2.
Learn P, Bach P . A decade of mortality reductions in major oncologic surgery: the impact of centralization and quality improvement. Med Care. 2010; 48(12):1041-9. DOI: 10.1097/MLR.0b013e3181f37d5f. View

3.
Ajani J, DAmico T, Bentrem D, Chao J, Cooke D, Corvera C . Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2022; 20(2):167-192. DOI: 10.6004/jnccn.2022.0008. View

4.
Ghaferi A, Birkmeyer J, Dimick J . Hospital volume and failure to rescue with high-risk surgery. Med Care. 2011; 49(12):1076-81. DOI: 10.1097/MLR.0b013e3182329b97. View

5.
Coupland V, Lagergren J, Luchtenborg M, Jack R, Allum W, Holmberg L . Hospital volume, proportion resected and mortality from oesophageal and gastric cancer: a population-based study in England, 2004-2008. Gut. 2012; 62(7):961-6. DOI: 10.1136/gutjnl-2012-303008. View