{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:35:56Z","timestamp":1760985356817},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,9,22]],"date-time":"2015-09-22T00:00:00Z","timestamp":1442880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA138640"],"award-info":[{"award-number":["R01CA138640"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["RP101207"],"award-info":[{"award-number":["RP101207"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Health care providers add multiple processes to the care of complex cancer patients, believing they prevent and\/or ameliorate complications. However, the relationship between these processes, complication remediation, and expenditures is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data for patients with cancer diagnoses undergoing colectomy, rectal resection, pulmonary lobectomy, pneumonectomy, esophagectomy, and pancreatic resection were obtained from hospital and inpatient physician Medicare claims for the years 2005\u20132009. Risk\u2010adjusted regression analyses measured the association between hospitalization costs and processes presumed to prevent and\/or remedy complications common to high\u2010risk procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After controlling for comorbidities, analysis identified associations between increased costs and use of multiple processes, including arterial lines (4\u201312% higher; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and pulmonary artery catheters (23\u201333% higher; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Epidural analgesia was not associated with higher costs. Consultations were associated with 24\u201044% (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) higher costs, and total parenteral nutrition was associated with 13\u201331% higher costs (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Many frequently utilized processes and services presumed to avoid and\/or ameliorate complications are associated with increased surgical oncology costs. This suggests that the patient\u2010centered value of each process should be measured on a procedure\u2010specific basis. Likewise, further attention should be focused on defining the efficacy of each of these costly, but frequently unproven, additions to perioperative care. <jats:italic>J. Surg. Oncol. 2015;112:610\u2013615<\/jats:italic>. \u00a9 2015 The Authors. <jats:italic>Journal of Surgical Oncology<\/jats:italic> Published by Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.24053","type":"journal-article","created":{"date-parts":[[2015,9,22]],"date-time":"2015-09-22T05:51:02Z","timestamp":1442901062000},"page":"610-615","source":"Crossref","is-referenced-by-count":11,"title":["Impact of processes of care aimed at complication reduction on the cost of complex cancer surgery"],"prefix":"10.1002","volume":"112","author":[{"given":"Marah N.","family":"Short","sequence":"first","affiliation":[{"name":"Baker Institute for Public Policy at Rice University Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian","family":"Ho","sequence":"additional","affiliation":[{"name":"Baker Institute for Public Policy and Department of Economics Rice University Houston Texas"},{"name":"Department of Medicine Baylor College of Medicine Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Aloia","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzg081"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/13.6.489"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/13.6.469"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199207000-00004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181bef697"},{"key":"e_1_2_6_7_1","unstructured":"American Cancer Society: Cancer Facts & Figures 2014 [Internet]. Atlanta: American Cancer Society 2014. Available from:http:\/\/www.cancer.org\/research\/cancerfactsstatistics\/cancerfactsfigures2014\/index"},{"key":"e_1_2_6_8_1","unstructured":"National Cancer Institute: Cancer Trends Progress Report 2011\u20132012 2012."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(03)00122-4"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2004.05.276"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.02.015"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.7155"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2014.08.002"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.03.084"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21888"},{"key":"e_1_2_6_16_1","unstructured":"PorterM Teisberg EO: Redefining Health Care: Creating Value\u2010based Competition on Results [Internet]. Boston MA Harvard Business School Publishing 2006. Available from:http:\/\/www4.hbr.org\/products\/7782\/7782p4.pdf."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23543"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28527"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181653d6b"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.2307\/3087467"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(02)00125-X"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(02)00057-7"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7547-5-7"},{"key":"e_1_2_6_24_1","unstructured":"Healthcare Cost and Utilization Project: Cost\u2010to\u2010charge ratio files [Internet]. Agency Healthc Res Qual 2011. Available from:http:\/\/www.hcup\u2010us.ahrq.gov\/db\/state\/costtocharge.jsp."},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2007.01.040"},{"key":"e_1_2_6_26_1","unstructured":"AHRQ: Making health care safer: a critical analysis of patient safety practices. [Internet]. 2001. Available from:http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24423049."},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199909000-00013"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(99)70152-2"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(99)70234-5"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(98)80011-5"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.5.1332"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2012.358"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1515\/fhep-2012-0016"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2006.07.021"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e32832b302b"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021108"},{"key":"e_1_2_6_38_1","unstructured":"MillerRD ErikssonLI FleisherLA et al (eds): Miller's Anesthesia (ed 7th). Churchill Livingstone Elsevier 2010."},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2013.3186"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056540"},{"key":"e_1_2_6_41_1","first-page":"129","article-title":"Comparison of two different methods of analgesia. Postoperative course after colorectal cancer surgery","volume":"39","author":"Rimaitis K","year":"2003","journal-title":"Medicina (Kaunas)"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.18.2455"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000237"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23746"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2009.04.002"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000767"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000628"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23710"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.3376"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-9914-1"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.24053","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjso.24053","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.24053","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.24053","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.24053","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T17:43:07Z","timestamp":1696354987000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.24053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,22]]},"references-count":49,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1002\/jso.24053"],"URL":"https:\/\/doi.org\/10.1002\/jso.24053","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,22]]}}}