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Healthcare resource utilisation and predictors for critical care unit admissions after primary bariatric surgery in an Australian public hospital setting: an exploratory study using a mixed-methods approach
Xia, Q and Campbell, J and Si, L and Ahmad, H and de Graaff, B and Ratcliffe, K and Turtle, J and Marrone, J and Kuzminov, A and Palmer, A, Healthcare resource utilisation and predictors for critical care unit admissions after primary bariatric surgery in an Australian public hospital setting: an exploratory study using a mixed-methods approach, Australian Health Review ISSN 1449-8944 (2021) [Refereed Article]
Objectives: An exploratory study that investigates resource use and predictors associated with Critical Care Unit (CCU) admission after primary bariatric surgery within the Tasmanian public healthcare system.
Methods: Inclusion criteria was patients undergoing primary bariatric surgery in the Tasmanian Health Service (THS) public hospital system between 07/07/2013 and 30/06/2019. THS provides two levels of CCU support: Intensive Care Unit (ICU) and High Dependency Unit (HDU). A mixed-methods approach was performed to examine the resource use and predictors associated with the overall and levels of CCU/HDU/ICU admission.
Results: N=254 patients entered the study. N=44 (17.3%) patients required 54 postoperative CCU admissions, with 43% requiring HDU support and 57% requiring more resource-demanding ICU support. Overall, CCU patients were more likely to have higher preoperative BMI, multimorbidity and undergo sleeve gastrectomy (SG) or gastric bypass (GBP). Patients undergoing gastric banding (GB) were more likely to require HDU rather than ICU support. Total hospital stays and median healthcare costs were higher for CCU patients (particularly ICU) than non-CCU patients.
Conclusions: Bariatric surgery patients often have significant comorbidities. This work demonstrates that patients with higher levels of morbidity are more likely to require critical care postoperatively. As this is elective surgery, being able to identify patients who are at increased risk is important to plan either the availability of critical care or even interventions to improve their pre-operative risk. Further work is required to refine the pre-existing conditions that contribute most to those requiring critical care management (particularly in the ICU setting) in the perioperative period.
|Item Type:||Refereed Article|
|Keywords:||health economics, health policy, primary health care, hospitals, health systems|
|Research Group:||Applied economics|
|Research Field:||Health economics|
|Objective Group:||Public health (excl. specific population health)|
|Objective Field:||Overweight and obesity|
|UTAS Author:||Xia, Q (Miss Qing Xia)|
|UTAS Author:||Campbell, J (Dr Julie Campbell)|
|UTAS Author:||Ahmad, H (Dr Hasnat Ahmad)|
|UTAS Author:||de Graaff, B (Dr Barbara de Graaff)|
|UTAS Author:||Marrone, J (Dr John Marrone)|
|UTAS Author:||Kuzminov, A (Dr Alexandr Kuzminov)|
|UTAS Author:||Palmer, A (Professor Andrew Palmer)|
|Deposited By:||Menzies Institute for Medical Research|
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