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Time is money: quantifying savings in outpatient appendectomy
Elise Taylor Bernard1, Daniel L Davenport1, Courtney M Collins1
1Department of Surgery, Acute Care Surgery, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.
Trauma Surgery & Acute Care Open
|January 29, 2019
Summary
Outpatient laparoscopic appendectomy significantly reduces hospital costs by approximately $1000 per patient. This study supports the widespread adoption of outpatient appendectomy protocols for improved resource utilization and patient care.
Area of Science:
- Surgical Innovation
- Health Economics
- Patient Outcomes
Background:
- Laparoscopic appendectomy is a safe outpatient procedure with high success rates.
- Cost-effectiveness of outpatient appendectomy has not been well-documented.
- This study investigates the financial benefits of an outpatient laparoscopic appendectomy protocol.
Purpose of the Study:
- To evaluate the cost savings associated with outpatient laparoscopic appendectomy.
- To assess the impact of an outpatient protocol on hospital resource utilization.
- To determine the feasibility of widespread implementation of outpatient appendectomy.
Main Methods:
- Retrospective cohort analysis of laparoscopic appendectomies (June 2013 - April 2017).
- Comparison of patient outcomes before and after implementing an outpatient protocol (January 2016).
- Assessment of appendicitis grade, length of stay (LOS), cost, net revenue, and profit margin.
Main Results:
- Discharge from postanesthesia care unit (PACU) to home increased from 3.7% to 29.7% post-protocol.
- Hospital costs averaged $4734 for PACU-to-home patients vs. $5781 for observation admissions, saving $1047 per patient.
- Mean LOS decreased across all groups; appendicitis grade did not predict need for observation.
Conclusions:
- Outpatient appendectomy offers significant cost savings of approximately $1000 per patient.
- Implementing outpatient pathways improves resource utilization.
- The established safety profile supports widespread adoption of outpatient appendectomy protocols.
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