Can Reoperative Surgery Be Profitable? Maximizing Reimbursement

ABSTRACT

It is interesting to review the topic of reoperative surgery from the aspect of cost-effectiveness or, worse yet, profitability for either the institution or surgeon. The majority of the published material focuses on indications, risk factors, and short- and long-term outcomes. The context of the discussion is framed by the question “Can you make money doing reoperative surgery?” The short answer is that if this is all you do, probably not. Few, if any, publications assess the impact a redo procedure has on the factors that directly affect the fee schedule: surgeon time consumption (intraoperative and postoperative), stress (physical and psychological), and malpractice effects. Far more work needs to be done to understand the cost and resource consumption effects of major reoperative surgery.

KEYWORDS

Reoperative surgery - cost - resource consumption

REFERENCES

• 1 Senagore A J, Duepree H J, Delaney C P, Dissanaike S, Brady K M, Fazio V W. Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease: similarities and differences.  Dis Colon Rectum. 2002;  45 485-490
• 2 Larach S, Ferrera A. Cost analysis. In: Jager R, Werner SD Laparoscopic Colorectal Surgery. New York; Churchill-Livingstone 2003
• 3 Duepree H J, Senagore A J, Delaney C P, Brady K M, Fazio V W. Advantages of laparoscopic resection for ileocecal Crohn's disease.  Dis Colon Rectum. 2002;  45 605-610
• 4 Delaney C P, Kiran R P, Senagore A J, Brady K, Fazio V W. Case-matched comparison and financial outcome after laparoscopic or open colorectal surgery.  Ann Surg. 2003;  238 67-72
• 5 Senagore A J, Brannigan A, Kiran R P, Brady K, Delaney C P. Diagnosis-related group assignment in laparoscopic and open colectomy: financial implications for payer and provider.  Dis Colon Rectum. 2005;  48 1016-1020
• 6 Pessaux P, Lermite E, Brehant O, Tuech J J, Lorimier G, Arnaud J P. Repeat hepatectomy for recurrent colorectal liver metastases.  J Surg Oncol. 2006;  93 1-7
• 7 MacLean A R, O'Connor B, Parkes R, Cohen Z, McLeod R S. Reconstructive surgery for failed ileal pouch-anal anastomosis: a viable surgical option with acceptable results.  Dis Colon Rectum. 2002;  45 880-886
• 8 Taheri P A, Butz D A, Dechert R, Greenfield L J. How DRGs hurt academic health systems.  J Am Coll Surg. 2001;  193 1-8 discussion 8-11
• 9 Delaney C P, Fazio V W, Senagore A J, Robinson B, Halverson A L, Remzi F H. 'Fast track' postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery.  Br J Surg. 2001;  88 1533-1538
• 10 Aust J B, Henderson W, Khuri S, Page C P. The impact of operative complexity on patient risk factors.  Ann Surg. 2005;  241 1024-1027 discussion 1027-1028