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[Comparative study of direct cost between open and laparoscopic cholecystectomy]
Guillermo Salinas-Escudero1, Víctor Raúl Zurita-Saldaña, Adolfo Gabriel Hernández-Garduño
1Hospital Infantil de México Federico Gómez, Secretaría de Salud, Distrito Federal, México.
Objective:
to compare the direct cost of open cholecystectomy (OCL) with laparoscopic cholecystectomy (LCL), using a microcosting approach.
Methods:
in patients who underwent cholecystectomy (C) in the Hospital General de Mexico, we collected patient age and sex, time in the operative room (OR), anesthesia and surgical procedure; health personal (HP) involved; materials (M) and medications consumed; medical instruments (MI) and medical equipment (ME) used.
Results:
there were 355 patients operated by C, were 248 included, 94 with CAB and 74 with CLP. CAB surgical time was longer than CLP (102 versus 82, p<0.00.1); CLP had a higher use of materials intraoperative ($5 329 versus $1 403, p<0.001). There are no differences in: cost for HP, MI and ME. The total direct cost was $7238 (US$615) for CAB and $12 507 (US$1 063) for CLP (p <0.001) at 11.76 Mexican pesos per dollar.
Conclusions:
the difference in costs between OCL and LCL is primarily explained by the cost of lab exams which represent 79% of the M cost for CLP.