TY - JOUR
T1 - Cost-effectiveness of laparoscopy in children
AU - Luks, François I.
AU - Logan, Judy
AU - Breuer, Christopher K.
AU - Kurkchubasche, Arlet G.
AU - Wesselhoeft, Conrad W.
AU - Tracy, Thomas F.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1999/9
Y1 - 1999/9
N2 - Background: Laparoscopy may offer fast recovery and improved cosmesis, but its cost has been perceived as excessive. Objective: To analyze the total hospital costs of laparoscopy vs open surgery. Design: Retrospective cost- effectiveness analysis evaluating all cases performed in a 36-month period (September 1995 to August 1998). Cases were evaluated for operative time, itemized cost of supplies, and length of hospitalization. Setting: Operations performed by pediatric surgeons in a tertiary care children's hospital. Patients: Consecutive children undergoing laparoscopic or open appendectomies, cholecystectomies, fundoplications, and splenectomies. Patients were not randomized to laparoscopy or open surgery. Interventions: Laparoscopic procedures performed with a core set of reusable equipment and a limited number of disposable instruments. Main Outcome Measures: Cost surplus of laparoscopy was evaluated, and compared with savings associated with decreased hospital stay, to obtain cost-effectiveness of laparoscopy per procedure. Results: There were 26 laparoscopic and 359 open appendectomies; 33 laparoscopic and 3 open cholecystectomies; 16 laparoscopic and 18 open fundoplications; and 16 laparoscopic and 7 open splenectomies. Excess operating costs per procedure were $442.00 for appendectomy, $634.60 for fundoplication, $847.50 for cholecystectomy, and $1551.30 for splenectomy. Hospital stay was decreased for all laparoscopies, resulting in an overall savings per laparoscopic procedure of $2369.90 for appendectomy, $5390.90 for fundoplication, $1161,00 for cholecystectomy, and $858.90 for splenectomy. Conclusions: Laparoscopy is cost-effective, particularly for fundoplication, appendectomy, and cholecystectomy. Detailing the costs of supplies, operating time, and length of stay allows interinstitutional comparison and critical cost-analysis of laparoscopy. With a more selective use of reusable instruments and further shortening of operative time, the global savings of laparoscopy may increase.
AB - Background: Laparoscopy may offer fast recovery and improved cosmesis, but its cost has been perceived as excessive. Objective: To analyze the total hospital costs of laparoscopy vs open surgery. Design: Retrospective cost- effectiveness analysis evaluating all cases performed in a 36-month period (September 1995 to August 1998). Cases were evaluated for operative time, itemized cost of supplies, and length of hospitalization. Setting: Operations performed by pediatric surgeons in a tertiary care children's hospital. Patients: Consecutive children undergoing laparoscopic or open appendectomies, cholecystectomies, fundoplications, and splenectomies. Patients were not randomized to laparoscopy or open surgery. Interventions: Laparoscopic procedures performed with a core set of reusable equipment and a limited number of disposable instruments. Main Outcome Measures: Cost surplus of laparoscopy was evaluated, and compared with savings associated with decreased hospital stay, to obtain cost-effectiveness of laparoscopy per procedure. Results: There were 26 laparoscopic and 359 open appendectomies; 33 laparoscopic and 3 open cholecystectomies; 16 laparoscopic and 18 open fundoplications; and 16 laparoscopic and 7 open splenectomies. Excess operating costs per procedure were $442.00 for appendectomy, $634.60 for fundoplication, $847.50 for cholecystectomy, and $1551.30 for splenectomy. Hospital stay was decreased for all laparoscopies, resulting in an overall savings per laparoscopic procedure of $2369.90 for appendectomy, $5390.90 for fundoplication, $1161,00 for cholecystectomy, and $858.90 for splenectomy. Conclusions: Laparoscopy is cost-effective, particularly for fundoplication, appendectomy, and cholecystectomy. Detailing the costs of supplies, operating time, and length of stay allows interinstitutional comparison and critical cost-analysis of laparoscopy. With a more selective use of reusable instruments and further shortening of operative time, the global savings of laparoscopy may increase.
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U2 - 10.1001/archpedi.153.9.965
DO - 10.1001/archpedi.153.9.965
M3 - Article
C2 - 10482214
AN - SCOPUS:0032832764
SN - 1072-4710
VL - 153
SP - 965
EP - 968
JO - Archives of Pediatrics and Adolescent Medicine
JF - Archives of Pediatrics and Adolescent Medicine
IS - 9
ER -