Minimally invasive versus open surgery in the Medicare population: a comparison of post-operative and economic outcomes

Surgical Endoscopy
Caleb J FanMartin A Makary

Abstract

Despite strong evidence demonstrating the clinical and economic benefits of minimally invasive surgery (MIS), utilization of MIS in the Medicare population is highly variable and tends to be lower than in the general population. We sought to compare the post-operative and economic outcomes of MIS versus open surgery for seven common surgical procedures in the Medicare population. Using the 2014 Medicare Provider Analysis and Review Inpatient Limited Data Set, patients undergoing bariatric, cholecystectomy, colectomy, hysterectomy, inguinal hernia, thoracic, and ventral hernia procedures were identified using DRG and ICD-9 codes. Adjusting for patient demographics and comorbidities, the odds of complication and all-cause 30-day re-admission were compared among patients undergoing MIS versus open surgery stratified by operation type. A generalized linear model was used to calculate the estimated difference in length of stay (LOS), Medicare claim cost, and Medicare reimbursement. Among 233,984 patients, 102,729 patients underwent an open procedure versus 131,255 who underwent an MIS procedure. The incidence of complication after MIS was lower for 5 out of the 7 procedures examined (OR 0.36-0.69). Re-admission was lower for MIS for...Continue Reading

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Citations

Oct 18, 2019·Neurologia Medico-chirurgica·Hiroaki ManabeKoichi Sairyo
Jan 24, 2020·Journal of Surgical Oncology·Tarik K YuceGregory B Auffenberg
Jun 5, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S AlyL I M Pernar
Jul 25, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Qinyu ChenTimothy M Pawlik
Feb 6, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Kota SaharaTimothy M Pawlik
May 28, 2019·Journal of Surgical Oncology·Byron D HughesAnthony J Senagore
Jan 15, 2022·ANZ Journal of Surgery·William JiangSatish K Warrier

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