Does implementing a general surgery residency program and resident involvement affect patient outcomes and increase care-associated charges?

Am J Surg. 2017 Jul;214(1):147-151. doi: 10.1016/j.amjsurg.2016.11.016. Epub 2016 Nov 14.

Abstract

Background: Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP.

Methods: We analyzed all laparoscopic appendectomies (lap-ap), cholecystectomies (lap-chole), and inguinal hernia repairs (IHR) performed before and after implementing a GRSP.

Results: Operative time significantly increased for lap-ap (p < 0.0001), lap-chole (p < 0.0001) and IHR (p = 0.03). Time to close the incision significantly increased for lap-ap (p < 0.0001), lap-chole (p = 0.006) and IHR (p = 0.03). Length of stay only increased for lap-ap (p = 0.04). Complication rates did not increase for any procedure. However, charges significantly increased for lap-ap (p < 0.0001), lap-chole (p < 0.0001), and IHR (p = 0.03).

Conclusions: Although a newly implemented GSRP caused increases in overall operative times, times to close incisions, and charges, it did not negatively impact patient outcomes.

Keywords: Costs; Education; General surgery residency program; Outcomes.

MeSH terms

  • Adult
  • Appendectomy / economics
  • Cholecystectomy, Laparoscopic / economics
  • Female
  • Florida
  • General Surgery / education*
  • Hernia, Inguinal / economics
  • Hernia, Inguinal / surgery
  • Humans
  • Internship and Residency*
  • Laparoscopy / economics
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications
  • Retrospective Studies