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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
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Delayed discharge does not decrease the cost of readmission after pulmonary lobectomy.

Raymond A Jean1, Alexander S Chiu2, Daniel J Boffa3

  • 1Department of Surgery, Yale School of Medicine, New Haven, CT; National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.

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Summary
This summary is machine-generated.

Expedited discharge after pulmonary lobectomy does not increase readmission costs. Early hospital discharge for lung cancer lobectomy is safe and reduces overall healthcare utilization.

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Area of Science:

  • Thoracic Surgery
  • Health Services Research
  • Oncology

Background:

  • Pulmonary lobectomy readmissions contribute to excess healthcare costs.
  • Expedited discharge may reduce costs but raises concerns about increased readmission rates and expenses.

Purpose of the Study:

  • To investigate the association between expedited discharge after pulmonary lobectomy and the risk of costly readmissions.
  • To compare 90-day readmission rates and associated costs across different discharge timings.

Main Methods:

  • Analysis of the Nationwide Readmission Database (2010-2014) for lung cancer lobectomies.
  • Categorization of patients (≥65 years) into expedited (1-3 days), routine (4-7 days), and late (>8 days) discharge groups.
  • Risk-adjusted comparison of 90-day readmission rates and costs.

Main Results:

  • Expedited discharge was associated with higher risk-adjusted readmission rates compared to routine and late discharges.
  • Expedited discharge significantly decreased index hospital costs by $4,066 (vs. routine) and $19,233 (vs. late).
  • No significant increase in readmission costs was observed for expedited discharges.

Conclusions:

  • Expedited discharge after lobectomy is linked to higher readmission rates but not increased readmission costs.
  • Prolonged hospital stays do not mitigate 90-day readmission risk following lobectomy.
  • Protocols promoting expedited discharge can lower overall healthcare utilization without escalating readmission expenses.