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Cost-effectiveness of laparoscopy in children
F I Luks1, J Logan, C K Breuer
1Division of Pediatric Surgery, Brown University School of Medicine, Providence, RI 02905, USA. Francois_Luks@brown.edu
Archives of Pediatrics & Adolescent Medicine
|September 11, 1999
Summary
Laparoscopic surgery is cost-effective for pediatric procedures like appendectomies and cholecystectomies, despite higher initial costs. Shorter hospital stays lead to significant overall savings, making laparoscopy a valuable surgical option.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Health Economics
Background:
- Laparoscopy offers benefits like faster recovery and improved cosmesis.
- Perceived high costs have limited widespread adoption of laparoscopic techniques.
Purpose of the Study:
- To conduct a cost-effectiveness analysis comparing laparoscopic surgery with traditional open surgery.
- Evaluate the total hospital costs associated with various pediatric surgical procedures.
Main Methods:
- Retrospective analysis of 36 months of pediatric surgical cases (appendectomies, cholecystectomies, fundoplications, splenectomies).
- Evaluation included operative time, itemized supply costs, and length of hospital stay.
- Cost surplus of laparoscopy was compared with savings from reduced hospitalization.
Main Results:
- Laparoscopic procedures incurred higher initial operating costs ($442-$1551 per procedure).
- However, significantly shorter hospital stays resulted in overall savings per procedure ($858-$5390).
- Appendectomy, cholecystectomy, and fundoplication demonstrated substantial cost-effectiveness with laparoscopy.
Conclusions:
- Laparoscopy is a cost-effective approach for pediatric appendectomies, cholecystectomies, and fundoplications.
- Detailed cost analysis, including supplies, operative time, and length of stay, is crucial for comparison.
- Optimizing reusable instrument use and operative time can further enhance the economic benefits of laparoscopy.