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Outpatient laparoscopic cholecystectomy: safe and cost effective?
R F Zegarra1, A K Saba, J L Peschiera
1Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.
Surgical Laparoscopy & Endoscopy
|January 23, 1998
Summary
Outpatient laparoscopic cholecystectomy (LC) is safe and cost-effective. This study found that outpatient LC significantly reduces hospitalization costs by 25% with no increase in patient complications.
Area of Science:
- Surgical Innovation
- Health Economics
Background:
- Laparoscopic cholecystectomy (LC) is the standard for symptomatic gallbladder disease.
- Reduced hospital stay is a key advantage of LC.
- Limited data exists comparing outpatient LC with overnight admission regarding readmissions and costs.
Purpose of the Study:
- To compare return visits and hospitalization costs for outpatient LC versus 24-hour observation LC.
- To assess patient morbidity and mortality between the two groups.
Main Methods:
- Retrospective analysis of 415 laparoscopic cholecystectomies (LCs) performed between January and December 1994.
- Comparison of a subset of outpatient LCs (n=229) and 24-hour observation LCs (n=90).
- Data collection included return visits, complications, and total hospitalization charges.
Main Results:
- Outpatient LC had a complication rate of 1.3%, while 24-hour observation LC had a rate of 2.2%.
- Average charges: $3,669.54 for outpatient LC vs. $4,890.37 for 24-hour observation LC (p < 0.0001).
- Outpatient LC demonstrated a 25% cost saving with no increase in morbidity or mortality.
Conclusions:
- Outpatient LC is a safe and cost-effective alternative to 24-hour observation for select patients.
- Implementing outpatient LC can lead to significant healthcare cost reductions.
- Further studies on readmission rates and long-term outcomes are warranted.
