Breakdown analysis of the cost development of pancreatic surgery after centralization
Year: 2026
Type: article
Abstract: Background: Centralization of pancreatic surgery has been shown to improve short-term outcomes and reduce postoperative mortality. Whether these clinical gains translate into lower costs is less clear, and evidence on the relationship between volume and cost remains inconsistent. In this study, we performed an itemized cost analysis of the pancreatic surgery process over the first decade following centralization. The primary objectives were to evaluate whether surgical costs have changed over time and to identify the main drivers of post-centralization costs. Methods: The retrospective single-centre study included 403 consecutive patients who underwent pancreatic resections at Oulu University Hospital between 2013-2021. Clinicopathological variables were collected from patient records. Direct hospital costs were calculated using inflation-adjusted tariffs for various subcategories: operation room (OR) costs, ward days, intensive care unit (ICU) stay, radiological imaging, laboratory tests, endoscopies and interventional radiology procedures. Results: €22,401, P<0.001), while complication rates did not differ (P=0.051). In quantile regression analysis, distal pancreatic resection was associated with lower costs than pancreatoduodenectomy in patients with no or minor complications (adjusted P<0.001). Associations between cost and vascular reconstruction among patients with major complications did not remain significant after correction for multiple testing. Conclusions: Costs of pancreatic surgery rose steadily during the first decade following centralization, despite a stable complication rate. In quantile regression analysis, only procedure type remained a significant cost driver after correction for multiple testing. OR costs and postoperative ward care accounted for most of the rising expenses.
Institutions: Oulu University Hospital, University of Oulu
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7222672845