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Cost-effectiveness of laparoscopic cholecystectomy in high-altitude areas
Xiaofeng Jing1,2, Ying Ma3, Defu Li3
1Department of Public Health, Chengdu Medical College, Chengdu, Sichuan, China.
Background:
At present, laparoscopic cholecystectomy (LC) is the primary treatment for gallstone. Although the application of LC has been widespread in developed countries, the cost-effectiveness of LC in high-altitude, low-resource regions remains unclear.
Methods:
We aimed to determine the cost-effectiveness of LC in the Qinghai Province and to provide a reference for other high-altitude area. We included 124 patients treated from 2018 to 2022 in Qinghai Traffic Hospital. We collected their demographic and clinical information and used the EuroQol Five Dimensions questionnaire to assess their quality of life. We performed cost-effectiveness analysis to evaluate LC and open cholecystectomy (OC). We also performed sensitivity and threshold analyses to determine the robustness of the results.
Results:
The OC and LC group demonstrated no significant differences in demographic characteristics. However, the hospital costs, the length of stay and quality-adjusted life years were significantly different between 2 groups (P < .05). The average cost was $1293 for LC and $2480 for OC. When the willingness to pay value is $2328 per quality-adjusted life year, the probability is >0.9, while when the willingness to pay value is $2793 per length of stay, the probability is >0.8.
Conclusion:
LC is less expensive and more effective than OC from the patient and society perspectives. Although there are some obstacles, it is feasible to promote LC in high-altitude, low-resource areas.
