Why the study?
Given shifting demographics toward older ages and increasing healthcare expenditures, the degree of center-level variation in elective abdominal aortic aneurysm repair costs required evaluation.
Is there significant hospital-level variation in costs for elective nonruptured abdominal aortic aneurysm repair, and is high-cost hospital status associated with worse clinical outcomes?
Population
Estimated 62,626 adult hospitalizations for elective nonruptured abdominal aortic aneurysm repair
Comparison
High-cost hospitals (top decile of costs) vs non-high-cost hospitals
Design
Retrospective database study using hierarchical mixed-effects models
Key result
Management at high-cost hospitals for elective abdominal aortic aneurysm repair was associated with increased odds of gastrointestinal (aOR 1.42; 95% CI 1.05-1.90) and infectious complications.
Authors
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Marked center variation in elective AAA repair costs highlights potential inefficiencies; leaves open whether standardization improves value.
Observational (n=62,626)
Yes
Is there significant hospital-level variation in costs for elective nonruptured abdominal aortic aneurysm repair, and is high-cost hospital status associated with worse clinical outcomes?
Odds Ratio: 1.42 (95% CI 1.05–1.9)
There is significant center-level variation in the cost of elective abdominal aortic aneurysm repair, with high-cost hospitals paradoxically associated with increased odds of gastrointestinal and infectious complications.
Curry et al. (2024) conducted an observational in Elective nonruptured abdominal aortic aneurysm (n=62,626). High-cost hospitals vs. Non-high-cost hospitals was evaluated on Gastrointestinal complications (adjusted OR 1.42, 95% CI 1.05-1.90). Management at high-cost hospitals for elective abdominal aortic aneurysm repair was associated with increased odds of gastrointestinal (aOR 1.42; 95% CI 1.05-1.90) and infectious complications.