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One hospital, one appendectomy: The cost effectiveness of a standardized doctor's preference card

David E Skarda1, Michael Rollins1, Seth Andrews2

  • 1Division of Pediatric Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT.

Journal of Pediatric Surgery
|March 26, 2015
PubMed

Insights

Standardizing surgical techniques and disposable device use for pediatric laparoscopic appendectomy significantly reduced costs. This approach improved value in pediatric surgery without increasing operative times or complications.

Area of Science:

  • Pediatric Surgery
  • Surgical Innovation
  • Healthcare Economics

Background:

  • Appendicitis management in children presents opportunities for cost reduction and value improvement.
  • Standardization of surgical procedures can minimize variation and enhance efficiency.

Purpose of the Study:

  • To evaluate the effectiveness of standardizing surgical technique and disposable device use for laparoscopic appendectomy in a pediatric tertiary care setting.
  • To assess the impact of a uniform doctor's preference card (DPC) on cost, operative time, and patient outcomes.

Main Methods:

  • A single standardized laparoscopic appendectomy technique was adopted by all 6 surgeons at a tertiary children's hospital.
  • Data were collected for pediatric patients undergoing laparoscopic appendectomy after implementing a uniform DPC, comparing them to a historical control group.

Main Results:

  • Implementation of the uniform DPC reduced device cost per appendectomy from $844.11 to $305.32.
  • Average operative times slightly increased from 34.8 to 37.0 minutes.
  • No significant differences were observed in postappendectomy outcomes between the groups.

Conclusions:

  • A uniform DPC and technical standardization for pediatric laparoscopic appendectomy can substantially decrease costs.
  • Cost reduction can be achieved without significantly impacting operative duration, hospital stay, or postoperative complications.
Abstract

Keywords:
AppendicitisCostLaparoscopyPediatricStandardizeValue

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