Respiratory complications after surgery in Vietnam: National estimates of the economic burden

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Respiratory complications after surgery in Vietnam: National estimates of the economic burden


JournalThe Lancet Regional Health – Western Pacific
Article typeJournal research article – Clinical research
Publication date – Mar – 2021
Authors – Bui MyHanh ,Khuong Quynh Long , Le Phuong Anh , Doan Quoc Hungab ,Duong Tuan Duce, Pham Thanh, Vietf Tran Tien Hung, Nguyen Hong Ha, Tran Binh Giang ,Duong Duc Hungh ,Hoang Gia Duh,Dao XuanThanh ,Le QuangCuong
Keywordseconomic burden, Outpatient visits, Postoperative respiratory complications, Re-hospitalization, vietnam
Open access – Yes
SpecialityCritical care, Health policy, Other
World region South-eastern Asia
Country: Vietnam
Language – English
Submitted to the One Surgery Index on April 1, 2021 at 11:12 pm
Abstract:

Background
Estimating the cost of postoperative respiratory complications is crucial in developing appropriate strategies to mitigate the global and national economic burden. However, systematic analysis of the economic burden in low- and middle-income countries is lacking.

Methods
We used the nationwide database of the Vietnam Social Insurance agency and extracted data from January 2017 to September 2018. The data contain 1 241 893 surgical patients undergoing one of seven types of surgery. Propensity score matching method was used to match cases with and without complications. We used generalized gamma regressions to estimate the direct medical costs; logistic regressions to evaluate the impact of postoperative respiratory complications on re-hospitalization and outpatient visits.

Findings
Postoperative respiratory complications increased the odds of re-hospitalization and outpatient visits by 3·49 times (95% CI: 3·35–3·64) and 1·39 times (95% CI: 1·34–1·45) among surgical patients, respectively. The mean incremental cost associated with postoperative respiratory complications occurring within 30 days of the index admission was 1053·3 USD (95% CI: 940·7–1165·8) per procedure, which was equivalent to 41% of the GDP per capita of Vietnam in 2018. We estimated the national annual incremental cost due to respiratory complications occurring within 30 days after surgery was 13·87 million USD. Pneumonia contributed the greatest part of the annual cost burden of postoperative respiratory complications.

Interpretation
The economic burden of postoperative respiratory complications is substantial at both individual and national levels. Postoperative respiratory complications also increase the odds of re-hospitalization and outpatient visits and increase the length of hospital stay among surgical patients.

OSI Number – 20990

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