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Original Research

EJCM. 2016; 4(3): 56-62


Aortic surgery cost and outcome at teaching vs. non-teaching hospitals

Azam Jan, Naseer Ahmed, S. Mumtaz Anwar Shah, Somiya Rehman, Alessio Rungatscher, Giuseppe Faggian.

Abstract
Objective: The purpose of this was to investigate, if there is a difference in cost and outcomes of Aortic surgery in teaching hospitals as compared to non-teaching hospitals.

Methods: The Healthcare Cost and Utilization Project (HCUP), sponsored by The Agency for Healthcare Research and Quality’s (AHRQ), includes the largest collection of longitudinal hospital care data in the United States of America. HCUP creates the National Inpatient Sample (NIS) to help conduct national and regional analyses of inpatient care. Using the NIS (2001-2012), we performed a retrospective cohort study that involved patients who underwent vascular. Bypass surgery involving major abdominal vessels. To identify these patients we used ICD (International Classification of Diseases) 9 procedure code 39.25. Using statistical analysis we compared the inpatient short term outcomes of these patients treated at teaching hospitals to non-teaching hospitals. Unweighted, it contains data from more than 7 million hospitalized patients stay each year. Weighted, it estimates more than 36 million hospitalizations nationally taken from more than 4,000 HCUP participating hospitals.

Results: A total of 15274 patients were analyzed from 2011-2012. There has been a marked decline in rate of Aortic bypass procedures per 100,000 discharges from 6.3 to 2.8 over the years 2001 to 2012.Also in these cases Routine discharges have decreased, the cost of stay and utilization of nursing home, rehabilitation and home health care has increased since 2001. There is no significant difference in inpatient mortality between teaching (3.06%) and non-teaching hosp. (4.21%). At teaching hospitals the cost of the admission for these aortic procedures was 6000$ higher, the length of stay was longer. Overall the use of nursing home, rehabilitation and home health care is more by the academic hospitals. But there is no difference in utilization of these facilities when it is analyzed relative to total number of procedures, between teaching and non-teaching hospitals.

Conclusions: Teaching hospitals has similar mortality for aortic bypass procedures as compared to nonteaching hospitals but at a higher cost of re-admission and prolonged hospitalization.

Key words: nursing home and rehabilitation, surgical mortality and morbidity, Vascular surgery



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