Volker R Jacobs1, John E Morrison. 1. Department of Surgery, Fayette Medical Center (FMC), Fayette, AL, USA. volkerjacobs@hotmail.com
Abstract
OBJECTIVE: To compare institutional costs for open versus laparoscopic inguinal hernia repair and its relationship to reimbursement in an ambulatory surgery center in the United States. METHOD: Analysis of institutional costs in US$ of 2006 for all nonreusables used in a laparoscopic total extraperitoneal (TEP) hernia repair using a polyester mesh compared with open hernia repair using polypropylene mesh. A comparison of the institution's disposable costs related to reimbursement at an ambulatory surgery center in Southeastern United States was performed to identify the most cost-effective procedure for the outpatient facility. RESULTS: As fixed and indirect costs of the ambulatory surgery center are similar for both procedures, a cost difference can only be found in direct disposable costs with that being US$ 235.57 for the procedure-specific disposables in the laparoscopic hernia repair as compared with US$ 117.15 for the open hernia repair. Cost for identical disposables used in both procedures amounted to US$ 32.57. Laparoscopic TEP hernia repair has a higher cost for procedure related disposables versus the open hernia repair at +US$ 118.42 mainly being due to the more costly polyester mesh. A flat rate reimbursement of US$ 1800 for a laparoscopic procedure compared with only US$ 950 for the open procedure minus all disposable cost results in a higher institutional income of +US&$ 731.58 (US$ 1531.86 vs. US$ 800.28), from which other institutional costs can be paid. CONCLUSIONS: Despite marginally higher procedure-related disposable costs for laparoscopic TEP hernia repair, the institutional income is remarkably higher owing to a better reimbursement for this procedure in ambulatory surgery centers. From the institution's point of view, laparoscopic hernia repair is by far the more cost-effective procedure when compared with an open hernia procedure at the present time.
OBJECTIVE: To compare institutional costs for open versus laparoscopic inguinal hernia repair and its relationship to reimbursement in an ambulatory surgery center in the United States. METHOD: Analysis of institutional costs in US$ of 2006 for all nonreusables used in a laparoscopic total extraperitoneal (TEP) hernia repair using a polyester mesh compared with open hernia repair using polypropylene mesh. A comparison of the institution's disposable costs related to reimbursement at an ambulatory surgery center in Southeastern United States was performed to identify the most cost-effective procedure for the outpatient facility. RESULTS: As fixed and indirect costs of the ambulatory surgery center are similar for both procedures, a cost difference can only be found in direct disposable costs with that being US$ 235.57 for the procedure-specific disposables in the laparoscopic hernia repair as compared with US$ 117.15 for the open hernia repair. Cost for identical disposables used in both procedures amounted to US$ 32.57. Laparoscopic TEP hernia repair has a higher cost for procedure related disposables versus the open hernia repair at +US$ 118.42 mainly being due to the more costly polyester mesh. A flat rate reimbursement of US$ 1800 for a laparoscopic procedure compared with only US$ 950 for the open procedure minus all disposable cost results in a higher institutional income of +US&$ 731.58 (US$ 1531.86 vs. US$ 800.28), from which other institutional costs can be paid. CONCLUSIONS: Despite marginally higher procedure-related disposable costs for laparoscopic TEP hernia repair, the institutional income is remarkably higher owing to a better reimbursement for this procedure in ambulatory surgery centers. From the institution's point of view, laparoscopic hernia repair is by far the more cost-effective procedure when compared with an open hernia procedure at the present time.
Authors: M M Poelman; B van den Heuvel; J D Deelder; G S A Abis; N Beudeker; R R Bittner; G Campanelli; D van Dam; B J Dwars; H H Eker; A Fingerhut; I Khatkov; F Koeckerling; J F Kukleta; M Miserez; A Montgomery; R M Munoz Brands; S Morales Conde; F E Muysoms; M Soltes; W Tromp; Y Yavuz; H J Bonjer Journal: Surg Endosc Date: 2013-05-25 Impact factor: 4.584
Authors: Bassey Enodien; Dominik Moser; Florian Kessler; Stephanie Taha-Mehlitz; Daniel M Frey; Anas Taha Journal: Int J Environ Res Public Health Date: 2022-09-29 Impact factor: 4.614