Cost of postoperative complications: How to avoid calculation errors

• Published in: World journal of gastroenterology : WJG Vol. 26; no. 21; pp. 2682 - 2690
• Main Authors: De la Plaza Llamas, Roberto, Ramia, José M
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 07-06-2020
• Subjects: Costs and Cost Analysis - methods; Costs and Cost Analysis - standards; Documentation - economics; Documentation - standards; Documentation - statistics & numerical data; Economics, Hospital - organization & administration; Economics, Hospital - standards; Economics, Hospital - statistics & numerical data; Hospital Costs - statistics & numerical data; Hospitalization - economics; Hospitalization - statistics & numerical data; Humans; Opinion Review; Postoperative Care - economics; Postoperative Complications - diagnosis; Postoperative Complications - economics; Postoperative Complications - therapy; Severity of Illness Index; Healthcare costs; Opportunity cost; Comprehensive complication index; Economic evaluation; Costs and cost analysis; Clavien-Dindo classification; Morbidity; Postoperative complications
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v26.i21.2682

Postoperative complications (PC) are a basic health outcome, but no surgery service in the world records and/or audits the PC associated with all the surgical procedures it performs. Most studies that have assessed the cost of PC suffer from poor quality and a lack of transparency and consistency. The payment system in place often rewards the volume of services provided rather than the quality of patients' clinical outcomes. Without a thorough registration of PC, the economic costs involved cannot be determined. An accurate, reliable appraisal would help identify areas for investment in order to reduce the incidence of PC, improve surgical results, and bring down the economic costs. This article describes how to quantify and classify PC using the Clavien-Dindo classification and the comprehensive complication index, discusses the perspectives from which economic evaluations are performed and the minimum postoperative follow-up established, and makes various recommendations. The availability of accurate and impartially audited data on PC will help reduce their incidence and bring down costs. Patients, the health authorities, and society as a whole are sure to benefit.