Cost-Effectiveness of Day Surgery With Remote Patient Monitoring for Acute Cholecystitis: Economic Modeling Study.
John Paul Kuwornu1, David Brain1, Kheng-Seong Ng2
1Australian Centre for Health Services Innovation (AusHSI), School of Public Health and Social Work, Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Level 7, 88 Musk Avenue, Kelvin Grove QLD, Brisbane, Queensland, 4059, Australia, +61 7 3138 6115.
JMIR Perioperative Medicine
|October 20, 2025
Summary
An acute day-surgery model for cholecystectomy patients saves hospital beds and reduces costs compared to traditional inpatient care. This innovative approach offers economic benefits without compromising patient outcomes.
Area of Science:
- Surgical Care Models
- Health Economics
- Patient Monitoring
Background:
- Reducing surgical wait times for cholecystectomy can mitigate adverse outcomes.
- Out-of-hospital remote monitoring alongside day-surgery lists is a potential solution.
- The cost-effectiveness of these innovative care models requires further exploration.
Purpose of the Study:
- To conduct a cost-effectiveness analysis comparing an acute day-surgery care model with remote patient monitoring to a conventional inpatient-centric model.
- To evaluate high-acuity cholecystitis cases requiring cholecystectomy.
Main Methods:
- A decision tree model was used to compare post-surgical complications, effectiveness (bed days saved, Quality-Adjusted Life Years [QALYs]), and costs over a 1-year horizon.
- Health care costs were analyzed from the Australian health care funder perspective in 2023 AUD.
- Sensitivity analyses (deterministic and probabilistic) were performed to assess uncertainty.
Main Results:
- The acute day-surgery model saved an average of 1.7 inpatient days per patient compared to the conventional model (1.5 vs. 3.2 days).
- Net health care costs were reduced by an average of AU $1,416 per case.
- No significant difference in QALYs was observed between the two models.
Conclusions:
- An acute day-surgery model with remote monitoring for cholecystitis patients offers potential bed day savings and economic advantages over inpatient-centric care.
- The findings suggest this model is a cost-effective alternative for selected patients.
- Uncertainty in QALY estimates is a noted limitation.
