ORCID Profile
0000-0002-4223-1670
Current Organisation
Alfred Health
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: IGI Global
Date: 2019
DOI: 10.4018/978-1-5225-5082-2.CH007
Abstract: Clinical costing is a powerful tool to bridge the disconnect between financial and clinical information, and is an ideal platform to conduct research aimed at informing value-based clinical decision making. This chapter will provide an ex le of the utility of activity-based costing to elucidate the costs of complications following pancreaticoduodenectomy, a high acuity procedure with high costs. It will show the significance of clear clinical costing in targeting cost containment in a tertiary hospital environment.
Publisher: Elsevier BV
Date: 2017
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.PAN.2017.12.008
Abstract: Pancreaticoduodenectomy (PD), also known as a Whipple procedure, is commonly performed for a variety of benign and malignant tumours, including of the pancreatic head and surrounding structures. PD is associated with low mortality but high morbidity and costs. Our objective was to describe the financial burden of complications following pancreaticoduodenectomy. We searched for articles using the MEDLINE, EMBASE, Cochrane and EconLit databases from the year 2000. Additional studies were identified by searching bibliographies. We included studies reporting on hospital cost or charge of in-hospital complications during the index PD admission. Studies including other surgeries but specifically reporting inpatient complication costs of PD were also included. Any type of PD was included. Data was collected using a data extraction table and a narrative synthesis was performed. We identified 15 eligible articles. All included articles were retrospective studies. Acceptable evidence for increased cost due to the presence and grade of complication was found. Strong evidence demonstrated the high rate of complications. Weak evidence linked complications with specific constituents of hospital cost. Complication grade was robustly linked with increased length of stay. Not enough evidence was found to demonstrate a link between PD complications and mortality or readmissions. Included studies were heterogeneous in setting, methodology, costing data, and grading systems. The presence and grade of PD complications increase hospital cost across erse settings. The costing methodology should be transparent and complication grading systems should be consistent in future studies. PROSPERO 2017:CRD42017058427.
Publisher: Springer Science and Business Media LLC
Date: 27-09-2021
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.HPB.2017.11.001
Abstract: A cost analyses of complications following pancreaticoduodenectomy (PD) was performed in a high volume hepato-biliary-pancreatic service. We hypothesised that costs are increased with both severity and number of complications we investigated the relationship between complications and specific cost centres. 100 patients from 2011 to 2016 were included. Data relating to their perioperative course were collected. Complications were documented by the Clavien-Dindo classification and costs were inflated and converted to 2017 USD. Mean hospital costs in complicated patients more than doubled those of uncomplicated patients ($28 330 vs. $57 150, p < 0.0001). Total hospital costs significantly increased with both severity and number of complications. This cost increase was influenced by medical consult, pathology, pharmacy, radiology, ward, intensive care, and allied health costs, but not operating theatre or anaesthesia costs. Postoperative pancreatic fistula, postoperative haemorrhage, delayed gastric emptying and infection were associated with cost differentials of $65 438, $74 079, $35 620 and $46 316 respectively over uncomplicated patients. The development of complications following PD is common, costly and associated with increased length of stay. Costs increased with greater complication severity, and specific complications. The in-depth breakdown of hospital costs suggests specific targets for cost containment.
Publisher: Wiley
Date: 03-05-2022
DOI: 10.1111/ANS.17749
Abstract: Colon cancer resection can be technically difficult in the obese (OB) population. Robotic surgery is a promising technique but its benefits remain uncertain in OB patients. The aim of this study is to compare OB versus non‐obese (NOB) patients undergoing robotic colon surgery, as well as OB patients undergoing robotic versus open or laparoscopic colonic surgery. A systematic review and meta‐analysis was performed. Primary outcome measures included length of stay (LOS), surgical site infection (SSI) rate, complications, anastomotic leak and oncological outcomes. A total of eight studies were included, with five comparing OB and NOB patients undergoing robotic colon surgery included in meta‐analysis. A total of 263 OB patients and 400 NOB patients formed the s le for meta‐analysis. There was no significant difference between the two groups in operative time, conversion to open, LOS, lymph node yield, anastomotic leak and postoperative ileus. There was a trend towards a significant increase in overall complications and SSI in the OB group (32.3% OB versus 26.8% NOB for complications, 14.2% OB versus 9.9% NOB for SSI). The three included studies comparing surgical techniques were too heterogeneous to undergo meta‐analysis. Robotic colon surgery is safe in obese patients, but high‐quality prospective evidence is lacking. Future studies should report on oncological safety and the cost‐effectiveness of adopting the robotic technique in these challenging patients.
Publisher: Elsevier BV
Date: 11-2022
No related grants have been discovered for Jason Wang.