BACKGROUND: The objective of this study was to compare the total hospital cost of laparoscopic (lap) and open colon surgery at a publicly funded academic institution. METHODS: Patients undergoing elective laparoscopic or open colon surgery for all indications at the University Health Network, Toronto, Canada, from April 2004 to March 2009 were included. Patient demographic, operative, and outcome data were reviewed retrospectively. Hospital costs were determined from the Ontario Case Costing Initiative, adjusted for inflation, and compared using the Mann-Whitney U test. Linear regression was used to analyze the relationship between length of stay and total hospital cost. RESULTS: There were 391 elective colon resections (223 lap/168 open, 15.4 % conversion). There was no difference in median age, gender, or Charlson score. Body mass index was slightly higher for laparoscopic surgery (27.5/25.9 lap/open; p = 0.008), while the American Society of Anesthesiologists score was slightly higher for open surgery. Median operative time was greater for laparoscopic surgery (224/196 min, lap/open; p = 0.001). There was no difference in complication rates (21.6/22.5 % lap/open; p = 0.900), reoperations (5.8/6.5 % lap/open; p = 0.833) or 30-day readmissions (7.6/12.5 % lap/open; p = 0.122). Number of emergency room visits was greater with open surgery (12.6/20.8 % lap/open; p = 0.037). Operative cost was higher for laparoscopic surgery ($4,171.37/3,489.29 lap/open; p = 0.001), while total hospital cost was significantly reduced ($9,600.22/12,721.41 lap/open; p = 0.001). Median length of stay was shorter for laparoscopic surgery (5/7 days lap/open; p = 0.000), and this correlated directly with hospital cost. CONCLUSIONS: Laparoscopic colon surgery is associated with increased operative costs but significantly lower total hospital costs. The cost savings is related, in part, to reduced length of stay with laparoscopic surgery.
BACKGROUND: The objective of this study was to compare the total hospital cost of laparoscopic (lap) and open colon surgery at a publicly funded academic institution. METHODS:Patients undergoing elective laparoscopic or open colon surgery for all indications at the University Health Network, Toronto, Canada, from April 2004 to March 2009 were included. Patient demographic, operative, and outcome data were reviewed retrospectively. Hospital costs were determined from the Ontario Case Costing Initiative, adjusted for inflation, and compared using the Mann-Whitney U test. Linear regression was used to analyze the relationship between length of stay and total hospital cost. RESULTS: There were 391 elective colon resections (223 lap/168 open, 15.4 % conversion). There was no difference in median age, gender, or Charlson score. Body mass index was slightly higher for laparoscopic surgery (27.5/25.9 lap/open; p = 0.008), while the American Society of Anesthesiologists score was slightly higher for open surgery. Median operative time was greater for laparoscopic surgery (224/196 min, lap/open; p = 0.001). There was no difference in complication rates (21.6/22.5 % lap/open; p = 0.900), reoperations (5.8/6.5 % lap/open; p = 0.833) or 30-day readmissions (7.6/12.5 % lap/open; p = 0.122). Number of emergency room visits was greater with open surgery (12.6/20.8 % lap/open; p = 0.037). Operative cost was higher for laparoscopic surgery ($4,171.37/3,489.29 lap/open; p = 0.001), while total hospital cost was significantly reduced ($9,600.22/12,721.41 lap/open; p = 0.001). Median length of stay was shorter for laparoscopic surgery (5/7 days lap/open; p = 0.000), and this correlated directly with hospital cost. CONCLUSIONS: Laparoscopic colon surgery is associated with increased operative costs but significantly lower total hospital costs. The cost savings is related, in part, to reduced length of stay with laparoscopic surgery.
Authors: Stefan Maartense; Michalda S Dunker; J Frederick Slors; Miguel A Cuesta; Dirk J Gouma; Sander J van Deventer; Ad A van Bodegraven; Willem A Bemelman Journal: Ann Surg Date: 2004-12 Impact factor: 12.969
Authors: Hans-Joachim Duepree; Anthony J Senagore; Conor P Delaney; Karen M Brady; Victor W Fazio Journal: Dis Colon Rectum Date: 2002-05 Impact factor: 4.585
Authors: Anthony J Senagore; Hans J Duepree; Conor P Delaney; Sharmilla Dissanaike; Karen M Brady; Victor W Fazio Journal: Dis Colon Rectum Date: 2002-04 Impact factor: 4.585
Authors: Celia N Robinson; G John Chen; Courtney J Balentine; Shubhada Sansgiry; Christy L Marshall; Daniel A Anaya; Avo Artinyan; Daniel Albo; David H Berger Journal: Ann Surg Oncol Date: 2011-01-07 Impact factor: 5.344
Authors: Mark Buunen; Ruben Veldkamp; Wim C J Hop; Esther Kuhry; Johannes Jeekel; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio Lacy; Hendrik J Bonjer Journal: Lancet Oncol Date: 2008-12-13 Impact factor: 41.316
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245
Authors: J W Fleshman; H Nelson; W R Peters; H C Kim; S Larach; R R Boorse; W Ambroze; P Leggett; R Bleday; S Stryker; B Christenson; S Wexner; A Senagore; D Rattner; J Sutton; A P Fine Journal: Dis Colon Rectum Date: 1996-10 Impact factor: 4.585
Authors: Ashley S Vergis; Sarah N Steigerwald; Faizal D Bhojani; Paul A Sullivan; Krista M Hardy Journal: Can J Surg Date: 2015-02 Impact factor: 2.089
Authors: Yoen T K van der Linden; Johannes A Govaert; Marta Fiocco; Wouter A van Dijk; Daniel J Lips; Hubert A Prins Journal: Int J Colorectal Dis Date: 2016-10-27 Impact factor: 2.571
Authors: Michał Pędziwiatr; Mateusz Wierdak; Michał Nowakowski; Magdalena Pisarska; Maciej Stanek; Michał Kisielewski; Maciej Matłok; Piotr Major; Stanisław Kłęk; Andrzej Budzyński Journal: Wideochir Inne Tech Maloinwazyjne Date: 2016-03-16 Impact factor: 1.195