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Cost-effectiveness of laparoscopic versus open appendectomy in developing nations: a Colombian analysis
Alejandro Ruiz-Patiño1, Samuel Rey2, German Molina2
1Medicine Faculty, Pontificia Universidad Javeriana, Bogota, Colombia.
The Journal of Surgical Research
|March 7, 2018
Summary
Laparoscopic appendectomy (LA) is a cost-effective alternative to open appendectomy (OA) in Colombia. LA offers savings in hospitalization costs due to fewer complications, making it a valuable option for resource-limited healthcare settings.
Area of Science:
- Health Economics
- Surgical Innovation
- Comparative Effectiveness Research
Background:
- Developing nations like Colombia face challenges in healthcare resource administration.
- Laparoscopic appendectomy (LA) has increased direct costs without clear clinical outcome benefits over open appendectomy (OA).
- Efficient resource allocation is crucial in healthcare settings with constant innovation.
Purpose of the Study:
- To determine the cost-effectiveness of laparoscopic appendectomy (LA) compared to open appendectomy (OA).
- To provide evidence for surgeons' clinical decision-making in resource-limited settings.
- To analyze the economic impact of LA versus OA in Colombia.
Main Methods:
- Retrospective cost-effectiveness analysis comparing OA and LA.
- Data collected from 377 clinical histories at a Colombian university hospital.
- Effectiveness measured by additional length of stay (LOS) due to complications; cost-effectiveness threshold set at $46 per additional LOS day.
Main Results:
- Laparoscopic appendectomy (LA) had a lower complication rate (10.4%) than open appendectomy (OA) (13.7%).
- Total cumulative costs for OA were $65,753 with 297 LOS days; for LA, costs were $66,425 with 271 LOS days.
- The incremental cost-effectiveness ratio (ICER) for LA was $25.86, indicating cost-effectiveness.
Conclusions:
- Laparoscopic appendectomy (LA) is a cost-effective alternative to open appendectomy (OA).
- LA demonstrates value by reducing hospitalization days due to complications, particularly in developing nations.
- The study supports LA as an efficient surgical option in resource-constrained environments.
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