Optimization of Health Expenditure in Liver Surgery
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Purpose
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.
| Condition | Intervention |
|---|---|
|
Hepatocellular Carcinoma Hilar Cholangiocarcinoma Intra Hepatic Cholangiocarcinoma Liver Metastasis |
Procedure: liver surgery |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Optimization of Health Expenditure in Major Surgery: Impact of a Mixed, Clinical and Ethnographic Approach in the Model of Liver Surgery |
- overall postoperative length of stay [ Time Frame: during the 3 months after the surgery ] [ Designated as safety issue: No ]
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.
- peroperative outcomes [ Time Frame: during the surgical procedure ] [ Designated as safety issue: Yes ]the peroperative outcomes are collected during the surgery and correspond to any event occured during the surgical intervention
- postoperative outcomes [ Time Frame: after the surgery until postoperative month 3 ] [ Designated as safety issue: Yes ]the postoperative outcomes correspond to any event occured after the surgical intervention. These outcomes include fistulae; bleeding...
- construct of pronostic models [ Time Frame: after the postoperative month 3 ] [ Designated as safety issue: No ]the construct of pronostic models include variables that affect the length of stay; morbidity and mortality
- evaluation of PMSI indicators [ Time Frame: after the postoperative month 3 ] [ Designated as safety issue: No ]this evaluation includes the analysis of PMSI indicators; their validity and the influence of centres on hepatectomies results
| Estimated Enrollment: | 3000 |
| Study Start Date: | September 2012 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
operated patients
this cohort includes patients who underwent a liver surgery whatever the pathology and whatever the surgical procedure
|
Procedure: liver surgery
this intervention type includes hepatectomies; wedge; segmentectomies etc...
|
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
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
the population corresponds to patients operated in one of the thirteen hospitals.
These hospitals are distributed on the french territory to ensure that the recruitment is representative of the general population
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
Contacts and Locations| Contact: olivier farges, MD, phD | Olivier.farges@bjn.aphp.fr |
| France | |
| Amiens North Hospital | Recruiting |
| Amiens, France | |
| Contact: jean marc regimbeau, MD, PhD +33 3 22 66 83 00 regimbeau.jean-marc@chu-amiens.fr | |
| Bordeaux Hospital | Recruiting |
| Bordeaux, France | |
| Contact: christophe laurent, MD, PhD +33 5 56 79 56 79 christophe.laurent@chu-bordeaux.fr | |
| Beaujon University Hospital | Recruiting |
| Clichy, France | |
| Contact: olivier farges, MD, PhD +33 1 40 87 50 00 Olivier.farges@bjn.aphp.fr | |
| Lille Regional Hospital | Recruiting |
| Lille, France | |
| Contact: pruvot francois rené, MD, PhD +33 3 20 44 59 62 francois-rene.pruvot@chru-lille.fr | |
| Lyon Hospital | Recruiting |
| Lyon, France | |
| Contact: christian ducerf, MD, PhD +33472071631 christian.ducerf@chu-lyon.fr | |
| Lyon Hospital | Recruiting |
| Lyon, France | |
| Contact: mustapha adham, MD, PhD +33 4 72 11 62 61 mustapha.adham@chu-lyon.fr | |
| Marseille Hospital | Recruiting |
| Marseille, France | |
| Contact: yves patrice letreut, MD, PhD +33 4 91 38 38 58 yves-patrice.letreut@ap-hm.fr | |
| Paoli calmette institute | Recruiting |
| Marseille, France | |
| Contact: jean robert delpero, MD, PhD +33 4-91-22-36-60 delperojr@marseille.fnclcc.fr | |
| Saint Antoine Hospital | Recruiting |
| Paris, France | |
| Contact: francois paye, MD, PhD + 33 1 49 28 25 33 francois.paye@sat.aphp.fr | |
| Saint Antoine Hospital | Recruiting |
| Paris, France | |
| Contact: olivier soubrane, MD, PhD +33 1 71 97 01 81 olivier.soubrane@sat.aphp.fr | |
| Strasbourg hospital | Recruiting |
| Strasbourg, France | |
| Contact: philippe bachellier, MD, PhD +33 3.88.12.71.71 philippe.bachellier@chru-strasbourg.fr | |
| Gustave Roussy institute | Recruiting |
| Villejuif, France | |
| Contact: dominique elias, MD, PhD +33 1 42 11 42 11 elias@igr.fr | |
| Sub-Investigator: diane goere, MD, PhD | |
| Paul Brousse Hospital | Recruiting |
| Villejuif, France | |
| Contact: eric vibert, MD, PhD + 33 1 45 59 34 11 eric.vibert@pbr.aphp.fr | |
More Information
No publications provided
| Responsible Party: | Centre Hospitalier Universitaire, Amiens |
| ClinicalTrials.gov Identifier: | NCT01715402 History of Changes |
| Other Study ID Numbers: | AOM 11060 |
| Study First Received: | October 22, 2012 |
| Last Updated: | May 2, 2013 |
| Health Authority: | France: Commission nationale de l'informatique et des libertés France: Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé |
Keywords provided by Centre Hospitalier Universitaire, Amiens:
|
liver tumor carcinoma cholangiocarcinoma metastasis |
Additional relevant MeSH terms:
|
Carcinoma Neoplasm Metastasis Cholangiocarcinoma Klatskin's Tumor Liver Neoplasms Carcinoma, Hepatocellular Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type |
Neoplasms Neoplastic Processes Pathologic Processes Adenocarcinoma Digestive System Neoplasms Neoplasms by Site Digestive System Diseases Liver Diseases |
ClinicalTrials.gov processed this record on June 18, 2013