title: A Population-Based Cost Analysis of Thoracoscopic Versus Open Lobectomy in Primary Lung Cancer.
abstract: Thoracoscopic lobectomy for primary lung cancer has become increasingly popular worldwide due to several advantages over open lobectomy including reduced pain, reduced length of hospital stay, and comparable oncologic outcomes. The costs of thoracoscopic versus conventional open lobectomy have been compared in several studies with variable results. We compared the costs of thoracoscopic versus open lobectomy in lung cancer patients in Taiwan.
  
  
  
  Patients who underwent lobectomy for primary lung cancer from the Taiwan National Health Insurance Research Database (NHIRD) between 2004 and 2010 were identified. Patient characteristics, operative data, and costs for each part of the hospitalization for surgery and 30 days of care after discharge were analyzed.
  
  
  
  A total of 5366 patients with complete clinical data who underwent either conventional open lobectomy (n = 3166, 59 %) or thoracoscopic lobectomy (n = 2200, 41 %) for primary lung cancer were identified from the database. Compared with open lobectomy, thoracoscopic lobectomy was associated with younger age, less comorbidity, shorter anesthesia times, and reduced lengths of hospital stay. Total hospital costs, operative costs, and other costs were significantly higher in the thoracoscopic group. The 30-day after discharge costs were significantly lower in the thoracoscopic group.
  
  
  
  Thoracoscopic lobectomy for primary lung cancer in Taiwan was associated with higher total hospital costs but lower 30 days after discharge costs than open lobectomy. These differences may have resulted from higher operative and instrument costs in the thoracoscopic group.
authors: Division of General Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.|Chung Shan Medical University, Taichung, Taiwan.|School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.
authors: Bing-Yen
authors: BY
authors: Wang
authors: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, 40201, Taiwan.
authors: Jing-Yang
authors: JY
authors: Huang
authors: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors: Jiunn-Liang
authors: JL
authors: Ko
authors: Chung Shan Medical University, Taichung, Taiwan.|Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.|Department of Respiratory Care, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan.
authors: Ching-Hsiung
authors: CH
authors: Lin
authors: Department of Cardiothoracic Surgery, Zhejiang University, Mingzhou Hospital, Ningbo, China.
authors: Yao-Hong
authors: YH
authors: Zhou
authors: Division of General Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan. 144474@cch.org.tw.
authors: Chang-Lun
authors: CL
authors: Huang
authors: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, 40201, Taiwan. 156283@cch.org.tw.
authors: Yung-Po
authors: YP
authors: Liaw
mesh_terms: D000230:Adenocarcinoma / Q000191:economics / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D018287:Carcinoma, Large Cell / Q000191:economics / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000191:economics / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000191:economics*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000191:economics* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D013624:Taiwan / Q000453:epidemiology; D020775:Thoracic Surgery, Video-Assisted / Q000191:economics*; D013908:Thoracotomy / Q000191:economics*