Xia, Q and Campbell, JA and Si, L and Ahmad, H and de Graaff, B and Ratcliffe, K and Turtle, J and Marrone, J and Kuzminov, A and Palmer, AJ, 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, 46, (1) pp. 42-51. ISSN 0156-5788 (2022) [Refereed Article]
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA
Objectives:The aim of this exploratory study was to investigate resource use and predictors associated with critical care unit (CCU) admission after primary bariatric surgery within the Tasmanian public healthcare system.
Methods: Patients undergoing primary bariatric surgery in the Tasmanian Health Service (THS) public hospital system between 7 July 2013 and 30 June 2019 were eligible for inclusion in this study. The THS provides two levels of CCU support, an intensive care unit (ICU) and a high dependency unit (HDU). A mixed-methods approach was performed to examine the resource use and predictors associated with overall CCU admission, as well as levels of HDU and ICU admission.
Results: There were 254 patients in the study. Of these, 44 (17.3%) 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 body mass index and multimorbidity and to undergo sleeve gastrectomy or gastric bypass. Patients undergoing gastric banding were more likely to require HDU rather than ICU support. Total hospital stays and median healthcare costs were higher for CCU (particularly ICU) patients than non-CCU patients.
Conclusions: Bariatric surgery patients often have significant comorbidities. This study demonstrates that patients with higher levels of morbidity are more likely to require critical care postoperatively. Because 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 patientsí preoperative risk. Further work is required to refine the pre-existing conditions that contribute most to the requirement for critical care management (particularly in the ICU setting) in the perioperative period.
|Item Type:||Refereed Article|
|Keywords:||bariatric surgery, intensive care, costs, economic evaluation, ICU, HDU, obesity|
|Research Group:||Applied economics|
|Research Field:||Health economics|
|Objective Group:||Evaluation of health and support services|
|Objective Field:||Health system performance (incl. effectiveness of programs)|
|UTAS Author:||Xia, Q (Miss Qing Xia)|
|UTAS Author:||Campbell, JA (Dr Julie Campbell)|
|UTAS Author:||Ahmad, H (Dr Hasnat Ahmad)|
|UTAS Author:||de Graaff, B (Dr Barbara de Graaff)|
|UTAS Author:||Palmer, AJ (Professor Andrew Palmer)|
|Web of Science® Times Cited:||1|
|Deposited By:||Menzies Institute for Medical Research|
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