Factors associated with interhospital variability in inpatient costs of liver and pancreatic resections

Howard Nelson-Williams, Faiz Gani, Arman Kilic, Gaya Spolverato, Yuhree Kim, Doris Wagner, Neda Amini, Aslam Ejaz, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


IMPORTANCE In an era of accountable care, understanding variation in health care costs is critical to reducing health care spending. OBJECTIVE To identify factors associated with increased hospital costs and quantify variations in costs among individual hospitals in patients undergoing liver and pancreatic surgery in the United States. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of total costs among 42 480 patients undergoing hepatopancreaticobiliary surgery from January 1, 2002, through December 31, 2011, using a nationally representative data set (Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project). Analysis was conducted in May 2015. MAIN OUTCOMES AND MEASURES Total inpatient costs and proportional variation in inpatient costs among individual hospitals. RESULTS Among the 42 480 patients who underwent liver or pancreatic resection, the median age was 62 years, 52.4%were female, and 72.9% had a Charlson Comorbidity Index of 2 or higher. The median cost for the entire cohort was $21 535 (interquartile range, $15 373-$31 104), varying from $3320 to $279 102 among individual hospitals. On multivariable analysis, increasing patient comorbidity (coefficient, 2000.30; 95%CI, 1363.33-2637.27; P 14 days: coefficient, 44 162.24; 95%CI, 43 125.56-45 198.92; P

Original languageEnglish (US)
Pages (from-to)155-163
Number of pages9
JournalJAMA Surgery
Issue number2
StatePublished - Feb 1 2016

ASJC Scopus subject areas

  • Surgery


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