Despite the growing acceptance of laparoscopic cholecystectomy the costs remain unclear.
Therefore, a detailed cost analysis was performed to determine potential savings.
As part of a continuing audit, data of 508 consecutive laparoscopic cholecystectomies have been prospectively collected.
Pre-intra-and postoperative variables were assessed by standardized questionnaires.
These data were used to estimate the average use of diagnostics, drug consumption, operation time, and hospital stay.
In addition, costs for loss in income, « hotel services, » diagnostic procedures, and for the operation itself were calculated in detail.
The total costs for a standard laparoscopic cholecystectomy were 3,395 deutsche marks (DM).
The costs for the operation itself represented 19%, « hotel services, » and medical treatment except the operation such as nursing, visits, or diagnostic procedures represented 47%, and the loss of income another 33% of the total costs.
Thus, most effective savings may be achieved by shortening the hospital stay and the time of inability to work.
However, each additional 30 min of operating time costed 146 DM (4.88 DM/min) and an « ideal » operation performed within 40 min and with a 3-day hospital stay would save 20% of the total and 31% of the hospital costs.
An increase in the number of operations per year would not have a relevant impact on the cost.
Disposable instruments would have increased the costs by 1,118 DM (33%).
Mots-clés Pascal : Cholécystectomie, Homme, Laparoscopie, Coût, Economie santé, Endoscopie, Chirurgie, Traitement
Mots-clés Pascal anglais : Cholecystectomy, Human, Laparoscopy, Costs, Health economy, Endoscopy, Surgery, Treatment
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0271984
Code Inist : 002B25G03. Création : 01/03/1996.