Archives of Hellenic Medicine

Last update:

29-Nov-2023

Arch Hellen Med, 40(6), November-December 2023, 786-796

ORIGINAL PAPER

Analysis of surgical cost of patients who were subjected to laparoscopic and open cholecystectomy.
Real-world data from a regional hospital in Greece

J. Fanourgiakis,^1,2 I. Lionda,¹ Ι. Dimotikalis,² N. Kontodimopoulos^1,3
¹Faculty of Social Sciences, Hellenic Open University, Patra,
²Department of Management Science and Technology, Hellenic Mediterranean University, Agios Nikolaos, Crete,
³Department of Health Economics, Medical School, National and Kapodistrian University of Athens, Athens, Greece

OBJECTIVE To assess the mean surgical cost of two methods of cholecystectomy, laparoscopic and open cholecystectomy.

METHOD A single-center, prospective study was conducted, which included all the patients who underwent laparoscopic or open cholecystectomy at the General Regional Hospital of Samos from 1.1.2021 to 31.12.2021. In the case report forms (CRF), the socio-demographic characteristics, medical history, and all consumption data (in physical units) from which costs derived during the cholecystectomy procedure, were recorded for all patients. The mean cost of each procedure (laparoscopic and open) was estimated using the micro-costing method and the bottom-up approach, from the insurance provider perspective.

RESULTS In total, 58 patients were subjected to cholecystectomy, 46 to laparoscopic and 12 to open cholecystectomy. The mean age of the patients for laparoscopic and open procedure was 59.48±13.5 years and 74.75±17.02 years, respectively. The mean (95% confidence interval, CI) total (direct) surgical cost for patients subjected to laparoscopic cholecystectomy was estimated at € 728.96 (€ 669.99–787.93) and for patients undergoing open cholecystectomy was estimated at € 445.64 (€ 388.40–502.87). The mean operative time for laparoscopic cholecystectomy was 118.43 minutes (min 60 minutes–max 210 minutes) (SD: 38.04) and for open cholecystectomy it was 135 minutes (min 90 minutes–max 195 minutes) (SD: 32.95). The mean length of hospital stay of patients who underwent laparoscopic cholecystectomy was 2.04 days (min 1 day, max 6 days) (SD: 1.35) and of patients who underwent open cholecystectomy was 7.92 days (min 2 days, max 22 days) (SD: 5.84). Considering the duration of hospitalization as a measure of effectiveness, the procedure of laparoscopic cholecystectomy was found to be cost effectiveness.

CONCLUSIONS The mean total surgical cost of laparoscopic was found to be relatively higher than that of open surgery, with medical consumables contributing the most. The results showed a shorter average operative time and a significantly shorter mean length of hospital stay in patients subjected to laparoscopic cholecystectomy.

Key words: Cholecystectomy, Cost analysis, Laparoscopic cholecystectomy, Open cholecystectomy.