Incremental Cost of Emergency Versus Elective Surgery

Area of Science:

• Surgical outcomes research
• Health economics
• Patient safety

Background:

• Emergency surgery is associated with higher costs and poorer patient outcomes than elective surgery.
• National data on the excess burden of emergency surgery is lacking.

Purpose of the Study:

• To quantify hospital costs and adjusted mortality risk for emergent versus elective surgical procedures.
• To estimate the potential cost savings from reducing emergent surgeries.

Main Methods:

• Analysis of Nationwide Inpatient Sample (NIS) data (2001-2010) for patients undergoing specific major surgeries.
• Utilized generalized linear models with propensity scores for cost difference calculations.
• Employed multivariable logistic regression to assess adjusted odds of mortality.

Main Results:

• Emergent surgery incurred higher costs: $8,741 (30%) for AAA repair, $5,310 (17%) for CABG, and $7,814 (53%) for colon resection.
• A 10% shift from emergent to elective procedures could save nearly $1 billion over a decade.
• Elective surgery was associated with significantly lower adjusted odds of mortality across all procedures.

Conclusions:

• Reducing the proportion of emergent surgeries for key procedures can yield substantial cost savings.
• Preventing emergent surgery through enhanced care coordination and screening presents a significant opportunity to improve patient survival and reduce healthcare expenditures.