Lap for Elderly

Laparoscopic Surgeries Underutilized In Older Patients A study of more than 233,000 Medicare patients who had common surgical procedures found that when compared to the general population, they underwent far fewer minimally invasive, laparoscopic procedures.¹ A report of these new findings, published in the September issue of Surgical Endoscopy, suggests that the disparities significantly reduce the potential for better care and cost savings.² The many, well-documented benefits of laparoscopic surgery include lower rates of complications, post-surgery pain, fewer infections and readmissions, along with shorter hospital stays and earlier discharges. When compared to traditional, open-case surgical procedures, laparoscopic procedures are more cost-effective as well. "This study shows there is an opportunity for Medicare and other payers to spend health care dollars more wisely so that they reward high-value care over low-value care" says Martin Makary, MD, MPH, professor of surgery at the Johns Hopkins University School of Medicine and a widely published expert on health care disparities and quality improvement programs.³ The Centers for Medicare & Medicaid Services (CMS) accounts for the second largest government expenditure and Medicare insures roughly a quarter of all Americans says Makary.⁴ According to the Government Accounting Office (GAO), Medicare expenditures were nearly $600 billion in 2016. Makary and his team focused on the use of laparoscopic surgery in elderly patients. Past studies have shown that MIS is associated with lower postoperative complications, readmissions, mortality, costs and shorter lengths of stay. These better outcomes would benefit the elderly as much as other patients. ⁵ "Makary says that complication prevention is a key goal in older, sometimes frail, patients because a single complication can lead to a cascade of harmful and costly events. The new study provides a comprehensive review of data for seven surgical procedures: cholecystectomy (gallbladder removal), bariatric, colectomy, hysterectomy, inguinal hernia, thoracic and ventral hernia.”⁶ “Data from the 233,984 Medicare patients (102,729 who underwent standard operations and 131,255 who underwent MIS procedures) showed that MIS complication rates were lower for five of seven procedures examined. Readmission rates after MIS were lower for six procedures (with the exception of inguinal hernia) and MIS was associated with less time in the hospital for six procedures.”⁷ Since its introduction over 30 years ago, laparoscopic surgery has been performed on millions of patients. Over the last 25 years numerous clinical studies have been published on the benefits of laparoscopic procedures and the significant cost savings associated with such procedures versus conventional surgical procedures. 1. “Minimally Invasive Surgeries Underused in Older Patients, New Study Finds” Johns Hopkins Medicine Press Release, March 5, 2018 2. “Minimally invasive versus open surgery in the Medicare population: a comparison of post-operative and economic outcomes” Surgical Endoscopy September 2018, Volume 32, Issue 9, pp 3874–3880 3. Op. Cite. 4. Op. Cite. 5. Op. Cite. 6. Op. Cite. 7. Op. Cite.