Related Experiment Video
Updated: May 26, 2026
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Long-term economic value analysis of reducing postoperative air leak following lung resection
Yi Yan1, Libo Tao1,2, Zhe Tao3
1Center for Health Policy and Technology Evaluation, Peking University Health Science Center, Beijing, China.
Background:
Pulmonary air leak (PAL) is one of the most frequent complications following lung resection. While its short-term clinical and economic impacts are well documented, the long-term economic value of interventions that reduce PAL duration remains poorly quantified. This study developed a novel methodological framework to estimate the long-term economic value of PAL reduction and to provide a rapid, quantitative approach for assessing the cost-effectiveness of related clinical interventions.
Methods:
We developed a hybrid decision-tree-Markov model simulating the natural history and health state transitions following pulmonary resection. Marginal analysis was applied to quantify the relationship between PAL duration (in days) and long-term costs (from both societal and healthcare system perspectives) as well as health outcomes measured in quality-adjusted life years (QALYs). Deterministic sensitivity analyses were performed on key model parameters to assess robustness.
Results:
Each additional day of PAL was associated with an increase in long-term societal costs of USD 390.4, healthcare system costs of USD 348.1, and a loss of 0.0087 QALYs. Using a willingness-to-pay (WTP) threshold equivalent to one times China's 2024 per capita GDP (USD 13,447.9), the monetized value of the QALY loss amounted to USD 117.6. Consequently, each 1-day reduction in PAL duration generated a total long-term economic benefit of USD 508.0 from a societal perspective and USD 465.7 from a healthcare system perspective. Sensitivity analyses confirmed the stability of these estimates across plausible parameter ranges.
Conclusions:
This study provides the first quantitative estimation of the long-term economic value of reducing PAL duration after lung resection. The derived marginal values offer a practical, evidence-based tool for rapidly evaluating the economic rationale of PAL-targeted interventions and can inform clinical decision-making, health technology assessment, and policy development in thoracic surgery.
