Impact of minimally invasive surgery on healthcare utilization, cost, and workplace absenteeism in patients with Incisional/Ventral Hernia (IVH)

• Published in: Surgical endoscopy Vol. 31; no. 11; pp. 4412 - 4418
• Main Authors: Mikami, Dean J., Melvin, W. Scott, Murayama, Michael J., Murayama, Kenric M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-11-2017; Springer Nature B.V
• Subjects: Abdominal Surgery; Absenteeism; Adult; Databases, Factual; Female; Gastroenterology; Gynecology; Health Care Costs - statistics & numerical data; Health services utilization; Hepatology; Hernia, Ventral - economics; Hernia, Ventral - surgery; Hernias; Humans; Incisional Hernia - economics; Incisional Hernia - surgery; Laparoscopy; Laparoscopy - economics; Laparoscopy - statistics & numerical data; Length of Stay - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Patient Acceptance of Health Care - statistics & numerical data; Proctology; Surgery; Workplace; Health care utilization; Workplace absenteesim; Incisional hernia; Ventral hernia
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-017-5488-y

Background
Incisional hernia repair is one of the most common general surgery operations being performed today. With the advancement of laparoscopy since the 1990s, we have seen vast improvements in faster return to normal activity, shorter hospital stays and less post-operative narcotic use, to name a few.
Objective
The key aims of this review were to measure the impact of minimally invasive surgery versus open surgery on health care utilization, cost, and work place absenteeism in the patients undergoing inpatient incisional/ventral hernia (IVH) repair.
Methods
We analyzed data from the Truven Health Analytics MarketScan
®
Commercial Claims and Encounters Database. Total of 2557 patients were included in the analysis.
Results
Of the patient that underwent IVH surgery, 24.5% (
n
 = 626) were done utilizing minimally invasive surgical (MIS) techniques and 75.5% (
n
 = 1931) were done open. Ninety-day post-surgery outcomes were significantly lower in the MIS group compared to the open group for total payment ($19,288.97 vs. $21,708.12), inpatient length of stay (3.12 vs. 4.24 days), number of outpatient visit (5.48 vs. 7.35), and estimated days off (11.3 vs. 14.64), respectively. At 365 days post-surgery, the total payment ($27,497.96 vs. $30,157.29), inpatient length of stay (3.70 vs. 5.04 days), outpatient visits (19.75 vs. 23.42), and estimated days off (35.71 vs. 41.58) were significantly lower for MIS group versus the open group, respectively.
Conclusion
When surgical repair of IVH is performed, there is a clear advantage in the MIS approach versus the open approach in regard to cost, length of stay, number of outpatient visits, and estimated days off.