Abstract
BackgroundThoracoscopic lobectomy for primary lung cancer has become increasingly popular worldwide due to several advantages over open lobectomy including reduced pain, reduced length of hospital stay, and comparable oncologic outcomes. The costs of thoracoscopic versus conventional open lobectomy have been compared in several studies with variable results. We compared the costs of thoracoscopic versus open lobectomy in lung cancer patients in Taiwan.MethodsPatients who underwent lobectomy for primary lung cancer from the Taiwan National Health Insurance Research Database (NHIRD) between 2004 and 2010 were identified. Patient characteristics, operative data, and costs for each part of the hospitalization for surgery and 30 days of care after discharge were analyzed.ResultsA total of 5366 patients with complete clinical data who underwent either conventional open lobectomy (n = 3166, 59 %) or thoracoscopic lobectomy (n = 2200, 41 %) for primary lung cancer were identified from the database. Compared with open lobectomy, thoracoscopic lobectomy was associated with younger age, less comorbidity, shorter anesthesia times, and reduced lengths of hospital stay. Total hospital costs, operative costs, and other costs were significantly higher in the thoracoscopic group. The 30-day after discharge costs were significantly lower in the thoracoscopic group.ConclusionsThoracoscopic lobectomy for primary lung cancer in Taiwan was associated with higher total hospital costs but lower 30 days after discharge costs than open lobectomy. These differences may have resulted from higher operative and instrument costs in the thoracoscopic group.
Highlights
Thoracoscopic lobectomy for primary lung cancer has become increasingly popular worldwide due to several advantages over open lobectomy including reduced pain, reduced length of hospital stay, and comparable oncologic outcomes
All costs extracted from the database were calculated in New Taiwan dollars (NTD/ TWD) and converted to United States dollars (USD) using the conversion, 1 USD = 30 TWD
The average age in the open lobectomy group was 66.63 ± 11.11 years compared with 61.70 ± 11.02 years in thoracoscopic lobectomy group (p \ 0.0001)
Summary
The released database was used strictly for research purposes, and all information that could potentially identify an individual patient was encrypted. This study was exempt from full review by the Internal Review Board in Changhua Christian Hospital. The NHIRD, established in 1997, includes nearly 99 % of the 23 million inhabitants of Taiwan and is managed by the National Health Research Institute of Taiwan. It provides clinical health information, including demographic data, primary and secondary diagnoses, clinical data, outpatient and inpatient visits, costs of services and procedures, and treatment patterns. The diagnosis codes used in this study were obtained from the International Classification of Disease, Tenth Revision, Clinical Modification code [ICD-10-CM]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
