Optimization of Health Expenditure in Liver Surgery

• Conditions: Hepatocellular Carcinoma; Intra Hepatic Cholangiocarcinoma; Hilar Cholangiocarcinoma; Liver Metastasis
• Interventions: Procedure: liver surgery

• Registration Number: NCT01715402
• Lead Sponsor: Centre Hospitalier Universitaire, Amiens

Brief Summary

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.

Detailed Description

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

Study Timeline

• Study Start: 2012-09
• Study First Submitted: 2012-10-22
• Study First Submitted QC: 2012-10-24
• Study First Posted: 2012-10-29
• Status Verified: 2017-02
• Last Update Submitted: 2017-02-03
• Last Update Posted: 2017-02-06
• Primary Completion: 2017-12
• Study Completion: 2018-12

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 3000

Inclusion Criteria

• elective liver surgery
• older than 18
• agreed to participate
• surgical procedure included procedures registered as "HLFA003 - 007 ; 009 - 011 ; 017 - 020 ; HLFC002 à 004 ; 027 ; 032 ; 037" in the PMSI database

Exclusion Criteria

• emergency surgery
• refused to participate

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
operated patients	liver surgery	this cohort includes patients who underwent a liver surgery whatever the pathology and whatever the surgical procedure

Primary Outcome Measures

Name	Time	Method
overall postoperative length of stay	during the 3 months after the surgery	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.

Secondary Outcome Measures

Name	Time	Method
peroperative outcomes	during the surgical procedure	the peroperative outcomes are collected during the surgery and correspond to any event occured during the surgical intervention
construct of pronostic models	after the postoperative month 3	the construct of pronostic models include variables that affect the length of stay; morbidity and mortality
evaluation of PMSI indicators	after the postoperative month 3	this evaluation includes the analysis of PMSI indicators; their validity and the influence of centres on hepatectomies results
postoperative outcomes	after the surgery until postoperative month 3	the postoperative outcomes correspond to any event occured after the surgical intervention. These outcomes include fistulae; bleeding...

Trial Locations

Locations (11)

Amiens North Hospital; 🇫🇷 Amiens, France

Bordeaux Hospital; 🇫🇷 Bordeaux, France

Beaujon University Hospital; 🇫🇷 Clichy, France

Lille Regional Hospital; 🇫🇷 Lille, France

Marseille Hospital; 🇫🇷 Marseille, France

Lyon Hospital; 🇫🇷 Lyon, France

Paoli calmette institute; 🇫🇷 Marseille, France

Saint Antoine Hospital; 🇫🇷 Paris, France

Strasbourg hospital; 🇫🇷 Strasbourg, France

Gustave Roussy institute; 🇫🇷 Villejuif, France

Paul Brousse Hospital; 🇫🇷 Villejuif, France