Original articleGeneral thoracicNinety-Day Costs of Video-Assisted Thoracic Surgery Versus Open Lobectomy for Lung Cancer
Section snippets
Patients and Methods
The institutional review board approved this investigation. A retrospective cohort study was conducted of adult patients with lung cancer treated with lobectomy between January 1, 2008 and September 30, 2011. Data were obtained from the MarketScan database—an all-payer database with inpatient, outpatient, and pharmacy claims [15]. Inclusion criteria were patients with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for lung cancer, an
Results
Between 2008 and 2011, 9,962 eligible patients underwent lobectomy; 31% of these lobectomies were VATS approaches. Table 1 shows the differences in patient characteristics and health care use by approach to lobectomy. There were no age differences. Statistically significant differences in the distributions of sex, comorbidity index, and health plan type were not clinically significant. Just less than half of all patients received epidural anesthesia, with significantly lower use among patients
Comment
There is growing interest in assessing and improving the value of health care delivery. Defined as health benefits per dollar spent, value may be increased by improving outcomes or decreasing costs, or both. A VATS approach to lobectomy is an example of an increasingly common intervention in thoracic operations that may improve quality and decrease costs. The existing body of evidence suggests equivalent oncologic efficacy and lower postoperative morbidity and mortality 1, 2, 3, 4, 5, 6, 7, 8,
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