Optimization of Health Expenditure in Liver Surgery
The aim of this study is to reduce the length of stay after liver surgery by taking account of objective quantitative clinical variables, subjective qualitative clinical variables and non clinical variables.
Intra Hepatic Cholangiocarcinoma
Procedure: liver surgery
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Optimization of Health Expenditure in Major Surgery: Impact of a Mixed, Clinical and Ethnographic Approach in the Model of Liver Surgery|
- overall postoperative length of stay [ Time Frame: during the 3 months after the surgery ] [ Designated as safety issue: No ]
the overall postoperative length of stay is defined as the hospitalization between the surgery and patient's discharge.
This period includes the readmission for at least 24 hours in case of outcomes related to the surgery.
- peroperative outcomes [ Time Frame: during the surgical procedure ] [ Designated as safety issue: Yes ]the peroperative outcomes are collected during the surgery and correspond to any event occured during the surgical intervention
- postoperative outcomes [ Time Frame: after the surgery until postoperative month 3 ] [ Designated as safety issue: Yes ]the postoperative outcomes correspond to any event occured after the surgical intervention. These outcomes include fistulae; bleeding...
- construct of pronostic models [ Time Frame: after the postoperative month 3 ] [ Designated as safety issue: No ]the construct of pronostic models include variables that affect the length of stay; morbidity and mortality
- evaluation of PMSI indicators [ Time Frame: after the postoperative month 3 ] [ Designated as safety issue: No ]this evaluation includes the analysis of PMSI indicators; their validity and the influence of centres on hepatectomies results
|Study Start Date:||September 2012|
|Estimated Study Completion Date:||December 2016|
|Estimated Primary Completion Date:||December 2016 (Final data collection date for primary outcome measure)|
this cohort includes patients who underwent a liver surgery whatever the pathology and whatever the surgical procedure
Procedure: liver surgery
this intervention type includes hepatectomies; wedge; segmentectomies etc...
a new dimension of the activity expected of physicians is to improve the safety of care on the one hand and the control of health care costs on the other.
key measures to help them are the publication of national recommendations, assessment of actual practices and the incentive to activity.
Internationalwide recent and concordant data suggest that
- quality and security of care, after an initial improvement, are going to stall
- scientific recommendations are rarely validated by an impact analysis and are not applied
- clinical data collected within an administrative framework are unreliable and too generalist
- the evaluation, especially in the surgical field, is based on indicators sometimes irrelevant and often unclear
Please refer to this study by its ClinicalTrials.gov identifier: NCT01715402
|Amiens North Hospital|
|Beaujon University Hospital|
|Lille Regional Hospital|
|Paoli calmette institute|
|Saint Antoine Hospital|
|Gustave Roussy institute|
|Paul Brousse Hospital|
|Principal Investigator:||Olivier FARGES, MD, phD||Beaujon University Hospital|