5 hours) and longer lengths of hospital stay (5.7 days versus 3.9 days). Furthermore, patients undergoing necessary lobectomy had a higher likelihood of experiencing an adverse event compared to patients undergoing wedge resection (0.57 versus 0.43) and had a higher number of adverse events on average (1.13 events versus 0.72 events). This study tracks 575 surgeons performing lobectomies or wedge resections using VATS (366 of whom were thoracic surgeons). Patients treated by thoracic surgeons using VATS lobectomy had lower inpatient costs and shorter length of stay compared with patients seen by general and other surgeons. While these effects were statistically significant at the 1% level, they were evidently small. No other statistically meaningful differences between thoracic and other surgeons were found for patients treated using VATS wedge resection or for other outcomes (i.

e., length of surgery, likelihood of adverse event, and number of adverse events). Surgeons’ six months experience with VATS varies by sample (Table 4). The most experienced surgeons, on average, are found in the sample of thoracic surgeons performing VATS lobectomies, 31.6 procedures. This average decreases to 22.3 procedures when considering all surgeons performing VATS wedge resections. Six months experience, for these surgeons, with open lobectomies and open wedge resection was lower, 5.4 procedures and 3.9 procedures, respectively, for the entire sample. Table 4 Volume and outcomes measures*. 3.1.

Multivariable Findings Given the possibility of confounders in these group comparisons of outcomes, we performed multivariable regression analyses, adjusting for a number of potential confounders, including patient demographics, metastatic versus primary cancer, comorbid conditions, APR-DRG severity index, and hospital characteristics. The results of these adjusted analyses of costs, surgery time, length of stay, likelihood GSK-3 of adverse event, and the number of adverse events are shown in Table 5. For ease of interpretation, we report the estimated marginal effects for each one of the 40 models presented in Table 5. The reported marginal effects measure the expected instantaneous change in each one of our five-outcome variables as a function of a change in surgeons’ VATS volume, while keeping all the other covariates constant. Note that, for each outcome of interest, we compared the estimated marginal effects obtained from an unadjusted analysis with the estimated marginal effects from the multivariable analysis described above. (Note: only adjusted findings are reported in Table 5). Table 5 Multivariable results for cost, utilization, and adverse events.