Aumente de procedimientos mínimo-invasores podría ahorrar los E.E.U.U. hospitales $280 a $340 millones anualmente: estudio

por Lauren Dubinsky, Senior Reporter | March 27, 2015
If U.S. hospitals performed more minimally-invasive procedures over traditional surgical procedures, it could save between $280 million and $340 million a year and significantly reduce complications and length of hospital stays, according to a new Johns Hopkins study published in JAMA-Surgery.

The researchers evaluated over 80,000 surgical cases from the National Inpatient Sample database, and tracked seven common post-surgical complications and billing charges for appendix, colon and lung operations. They chose those three operations because traditional surgery and minimally-invasive procedures are both the standards of care.

The researchers looked at two theoretical scenarios — if all U.S. hospitals increased their use of minimally-invasive procedures by 50 percent and if “low-utilization” hospitals increased their use of those procedures to the degree of hospitals performing in the upper one-third. They compared the actual cost of traditional surgery for each of the patients with the estimated costs for the same patients hypothetically undergoing minimally-invasive procedures.

They found that if the hospitals increased the amount of minimally-invasive procedures by 50 percent, they would avoid 3,578 complications, reduce hospital stays by 144,863 days and save $288 million per year. If the low-utilizers rose to the high-performer’s level, there would be 4,306 fewer complications, 169,819 fewer hospital days and savings of $337 million per year.

The researchers hope that these findings will influence hospital leaders to consider performing more minimally-invasive procedures in their hospitals, when appropriate, and also develop more streamlined division of labor so surgeons with minimally-invasive skills have the ability to operate on qualified patients.

"The decision to perform an open versus minimally invasive procedure should be made according to each patient's specific case and overall health, among other factors," Dr. Marty Makary, professor of surgery at the Johns Hopkins University School of Medicine, said in a statement. "But our results make a very strong case that minimally invasive surgery is grossly underutilized and, at a minimum, ought to be offered to patients more often."

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