Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis Cancer
Objectives. Retroperitoneal lymph node dissection (RPLND) outcomes for testis cancer originate mostly from single-center series. We characterized population-based utilization, costs, and outcomes and assessed whether higher volume affects outcomes. Methods and Materials. Using the US Nationwide Inp...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2012/189823 |
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| author | Hua-yin Yu Nathanael D. Hevelone Sunil Patel Stuart R. Lipsitz Jim C. Hu |
| author_facet | Hua-yin Yu Nathanael D. Hevelone Sunil Patel Stuart R. Lipsitz Jim C. Hu |
| author_sort | Hua-yin Yu |
| collection | DOAJ |
| description | Objectives. Retroperitoneal lymph node dissection (RPLND) outcomes for testis cancer originate mostly from single-center series. We characterized population-based utilization, costs, and outcomes and assessed whether higher volume affects outcomes. Methods and Materials. Using the US Nationwide Inpatient Sample from 2001–2008, we identified 993 RPLND and used propensity score methods to assess utilization, costs, and inpatient outcomes based on hospital surgical volume. Results. 51.6% of RPLND were performed at hospitals where there were two or fewer cases per year. RPLND was more commonly performed at large urban teaching hospitals, where men were younger, more likely to be white and earning incomes exceeding the 50th percentile (all P≤.05). Higher hospital volumes were associated with fewer complications and more routine home discharges (all P≤.047). However, higher volume hospitals had more transfusions (P=.004) and incurred $1,435 more in median costs (P<.001). Limitations include inability to adjust for tumor characteristics and absence of outpatient outcomes. Conclusions. Sociodemographic differences exist between high versus low volume RPLND hospitals. Although higher volume hospitals had more transfusions and higher costs, perhaps due to more complex cases, they experienced fewer complications. However, most RPLND are performed at hospitals where there were two or fewer cases per year. |
| format | Article |
| id | doaj-art-37966f47e8cc4a738fc71091d9f1b931 |
| institution | Kabale University |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
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| series | Advances in Urology |
| spelling | doaj-art-37966f47e8cc4a738fc71091d9f1b9312025-02-03T06:00:35ZengWileyAdvances in Urology1687-63691687-63772012-01-01201210.1155/2012/189823189823Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis CancerHua-yin Yu0Nathanael D. Hevelone1Sunil Patel2Stuart R. Lipsitz3Jim C. Hu4Division of Urology, Brigham and Women's Hospital, Harvard Medical School, 1153 Centre Street, Suite 4420, Boston, MA 02130, USACenter for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, 1153 Centre Street, Suite 4420, Boston, MA 02130, USADivision of Urology, Brigham and Women's Hospital, Harvard Medical School, 1153 Centre Street, Suite 4420, Boston, MA 02130, USACenter for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, 1153 Centre Street, Suite 4420, Boston, MA 02130, USADepartment of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USAObjectives. Retroperitoneal lymph node dissection (RPLND) outcomes for testis cancer originate mostly from single-center series. We characterized population-based utilization, costs, and outcomes and assessed whether higher volume affects outcomes. Methods and Materials. Using the US Nationwide Inpatient Sample from 2001–2008, we identified 993 RPLND and used propensity score methods to assess utilization, costs, and inpatient outcomes based on hospital surgical volume. Results. 51.6% of RPLND were performed at hospitals where there were two or fewer cases per year. RPLND was more commonly performed at large urban teaching hospitals, where men were younger, more likely to be white and earning incomes exceeding the 50th percentile (all P≤.05). Higher hospital volumes were associated with fewer complications and more routine home discharges (all P≤.047). However, higher volume hospitals had more transfusions (P=.004) and incurred $1,435 more in median costs (P<.001). Limitations include inability to adjust for tumor characteristics and absence of outpatient outcomes. Conclusions. Sociodemographic differences exist between high versus low volume RPLND hospitals. Although higher volume hospitals had more transfusions and higher costs, perhaps due to more complex cases, they experienced fewer complications. However, most RPLND are performed at hospitals where there were two or fewer cases per year.http://dx.doi.org/10.1155/2012/189823 |
| spellingShingle | Hua-yin Yu Nathanael D. Hevelone Sunil Patel Stuart R. Lipsitz Jim C. Hu Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis Cancer Advances in Urology |
| title | Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis Cancer |
| title_full | Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis Cancer |
| title_fullStr | Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis Cancer |
| title_full_unstemmed | Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis Cancer |
| title_short | Hospital Surgical Volume, Utilization, Costs and Outcomes of Retroperitoneal Lymph Node Dissection for Testis Cancer |
| title_sort | hospital surgical volume utilization costs and outcomes of retroperitoneal lymph node dissection for testis cancer |
| url | http://dx.doi.org/10.1155/2012/189823 |
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