Optimization of Health Expenditure in Liver Surgery
Study Details
Study Description
Brief Summary
The aim of this study is to reduce the length of stay after liver surgery by taking account of objective quantitative clinical variables, subjective qualitative clinical variables and non clinical variables.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
a new dimension of the activity expected of physicians is to improve the safety of care on the one hand and the control of health care costs on the other.
key measures to help them are the publication of national recommendations, assessment of actual practices and the incentive to activity.
Internationalwide recent and concordant data suggest that
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quality and security of care, after an initial improvement, are going to stall
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scientific recommendations are rarely validated by an impact analysis and are not applied
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clinical data collected within an administrative framework are unreliable and too generalist
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the evaluation, especially in the surgical field, is based on indicators sometimes irrelevant and often unclear
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| operated patients this cohort includes patients who underwent a liver surgery whatever the pathology and whatever the surgical procedure |
Procedure: liver surgery
this intervention type includes hepatectomies; wedge; segmentectomies etc...
|
Outcome Measures
Primary Outcome Measures
- overall postoperative length of stay [during the 3 months after the surgery]
the overall postoperative length of stay is defined as the hospitalization between the surgery and patient's discharge. This period includes the readmission for at least 24 hours in case of outcomes related to the surgery.
Secondary Outcome Measures
- peroperative outcomes [during the surgical procedure]
the peroperative outcomes are collected during the surgery and correspond to any event occured during the surgical intervention
- postoperative outcomes [after the surgery until postoperative month 3]
the postoperative outcomes correspond to any event occured after the surgical intervention. These outcomes include fistulae; bleeding...
- construct of pronostic models [after the postoperative month 3]
the construct of pronostic models include variables that affect the length of stay; morbidity and mortality
- evaluation of PMSI indicators [after the postoperative month 3]
this evaluation includes the analysis of PMSI indicators; their validity and the influence of centres on hepatectomies results
Eligibility Criteria
Criteria
Inclusion Criteria:
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elective liver surgery
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older than 18
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agreed to participate
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surgical procedure included procedures registered as "HLFA003 - 007 ; 009 - 011 ; 017
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020 ; HLFC002 à 004 ; 027 ; 032 ; 037" in the PMSI database
Exclusion Criteria:
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emergency surgery
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refused to participate
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Amiens North Hospital | Amiens | France | ||
| 2 | Bordeaux Hospital | Bordeaux | France | ||
| 3 | Beaujon University Hospital | Clichy | France | ||
| 4 | Lille Regional Hospital | Lille | France | ||
| 5 | Lyon Hospital | Lyon | France | ||
| 6 | Marseille Hospital | Marseille | France | ||
| 7 | Paoli calmette institute | Marseille | France | ||
| 8 | Saint Antoine Hospital | Paris | France | ||
| 9 | Strasbourg hospital | Strasbourg | France | ||
| 10 | Gustave Roussy institute | Villejuif | France | ||
| 11 | Paul Brousse Hospital | Villejuif | France |
Sponsors and Collaborators
- Centre Hospitalier Universitaire, Amiens
- Assistance Publique - Hôpitaux de Paris
Investigators
- Principal Investigator: Olivier FARGES, MD, phD, Beaujon University Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- AOM 11060