OBJECTIVES

This study aims to analyze health resource utilization and costs of rectal cancer surgery in Korea.

METHODS

Using the 2016 National Inpatient Sample (NIS) dataset of Health Insurance Review and Assessment Service (HIRA), which covers approximately 13% of total hospitalized patients in Korea, we identified claims with both with Low Anterior Resection (LAR) and a rectal cancer (C20) and subdivided them by surgical modality for further analysis.

RESULTS

A total of 538 patients were identified. Eighty-four percent of surgeries were performed laparoscopically (Laparoscopic: 454, Open: 84). Median age of overall patients was 64.3 (male: 64%, female: 36%). Approximately 70% (371/538) of surgeries were performed in upper general hospitals of which 300 were performed in capital areas. The median cost from hospital admission to discharge was USD 7,732 (mean: USD 8,620). The cost of laparoscopy and open were USD 7,767 (mean: USD 8,469) and USD 7,441(mean: USD 9,436), respectively. Surgery and treatment were responsible for 60% of the cost, which was greater by USD 823 in the laparoscopic group due to greater use of devices and consumables. However, hospital stay, ICU care and medication costs were higher in the open group with a greater variation. The overall median length of stay (LOS) was 12 days (Laparoscopic: 12 days, Open:13 days). One day shorter LOS resulted in a savings of USD 261 in hospital ward costs. LOS differed by hospital types (P<0.05) where it was shortest in upper-general hospitals (11 days), followed by hospitals (12 days) and general hospitals (15 days).

CONCLUSIONS

The cost of rectal cancer surgery in Korea is substantial. There was no significant cost difference by surgical modality (p= 0.0905), but further comparative cost studies considering patients’ baseline clinical status and disease severity should be conducted.