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Economic evaluation of minimally invasive colectomy
Rabih M Salloum1, Debra C Bulter, Seymour I Schwartz
1Department of Surgery, University of Rochester, Strong Memorial Hospital, Rochester, NY 14642, USA.
Background:
We performed a cost-benefit analysis of minimally invasive colectomy (MIC) with the appreciation that this approach extends the duration of the operation and requires additional instruments and equipment when compared with the open procedure. These negatives may be offset by decreased pain, earlier initiation of oral feeding, and a shorter hospitalization.
Study Design:
We reviewed operating room records of all open colectomies (OCs) and MICs performed at Strong Memorial Hospital between January 1, 2000, and March 31, 2004, as defined by CPT codes. Operating room times, total operating room costs, lengths of hospital stay, and total hospital costs were calculated for each procedure.
Results:
Sixty-eight right hemicolectomies (54 OCs and 14 MICs) were performed. Operating room time was significantly longer for MIC compared with OC (214 +/- 41 minutes versus 170 +/- 56 minutes, p = 0.01). Length of hospital stay was shorter for MIC compared with OC (4.5 +/- 1.3 days versus 7.4 +/- 2.5 days, p = 0.004). There were 131 left hemicolectomies (104 OCs and 27 MICs) performed. Operating room time was significantly longer for left MIC compared with left OC (256 +/- 46 minutes versus 213 +/- 60 minutes, p = 0.005). Length of hospital stay was shorter for left MIC than for left OC (4.4 +/- 1.3 days versus 7.9 +/- 3.0 days, p = 0.001). Total hospital costs were significantly lower for MIC compared with OC (8,580 US dollars +/- 1,358 US dollars versus 10,303 US dollars +/- 3,299 US dollars, p = 0.046).
Conclusions:
MIC is associated with a significantly longer operating room time and a shorter hospital stay than OC. Operating room cost is significantly higher for MIC, but total hospital cost is lower. MIC is cost effective and results in significant savings to the health-care system.
Insights
Minimally invasive colectomy (MIC) takes longer in the operating room but results in shorter hospital stays and lower overall costs compared to open colectomy (OC). This makes MIC a cost-effective surgical approach with significant healthcare savings.
Area of Science:
- Colorectal Surgery
- Surgical Outcomes Research
- Health Economics
Background:
- Minimally invasive colectomy (MIC) may involve longer operative times and increased equipment costs compared to open colectomy (OC).
- Potential benefits of MIC include reduced pain, earlier oral feeding, and shorter hospitalizations.
Purpose of the Study:
- To conduct a cost-benefit analysis comparing minimally invasive colectomy (MIC) and open colectomy (OC).
- To evaluate the economic implications and clinical outcomes of MIC versus OC.
Main Methods:
- A retrospective review of operating room records for open colectomies (OCs) and minimally invasive colectomies (MICs) performed between January 1, 2000, and March 31, 2004.
- Calculation of operating room times, total operating room costs, length of hospital stay, and total hospital costs for each procedure.
Main Results:
- MIC procedures (right and left hemicolectomies) had significantly longer operating room times compared to OC (p=0.01 for right, p=0.005 for left).
- Hospital stays were significantly shorter for MIC compared to OC (p=0.004 for right, p=0.001 for left).
- Total hospital costs were significantly lower for MIC ($8,580 ± $1,358) compared to OC ($10,303 ± $3,299) (p=0.046).
Conclusions:
- Minimally invasive colectomy (MIC) is associated with longer operating room times but shorter hospital stays than open colectomy (OC).
- While operating room costs are higher for MIC, overall hospital costs are significantly lower.
- MIC is a cost-effective procedure, yielding substantial savings for the healthcare system.
