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  1. Cost-effectiveness of laparoscopy in children.

    Article - En anglais

    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. (...)

    Mots-clés Pascal : Chirurgie, Enfant, Homme, Technique, Laparoscopie, Analyse coût efficacité, Economie santé, Durée, Intervention, Hospitalisation, Etats Unis, Amérique du Nord, Amérique, Evaluation

    Mots-clés Pascal anglais : Surgery, Child, Human, Technique, Laparoscopy, Cost efficiency analysis, Health economy, Duration, Operation, Hospitalization, United States, North America, America, Evaluation

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0491272

    Code Inist : 002B25N. Création : 22/03/2000.