A COST-EFFECTIVENESS COMPARISON OF THE OPEN AND LAPAROSCOPIC APPENDECTOMIES FOR PEDIATRIC PATIENTS

Year 2019, Volume: 4 Issue: 3, 151 - 161, 13.12.2019

Amita Bhadauria Amogh Bhatnagar

https://doi.org/10.23884/ijhsrp.2019.4.3.01

Abstract

Objectives: Laparoscopic appendectomy (LA)
is preferred to open appendectomy (OA), as it is less invasive. However, it is
debatable whether LA is more cost-effective. We compared the cost-benefits of
LA with OA, using the entire pediatric inpatient hospital data in USA.

Methods: The
Kids' Inpatient Database (KID) shows that 51,007 pediatric patients were
subjected to laparoscopic appendectomy and 12,668
to open appendectomy during 2010-12 across the
USA. This dataset was used to assess the cost-effectiveness
of LA and OA, while controlling for the
demographic characteristics of patients (e.g. age and gender), their background
(e.g., place of residence), and complexity of surgery (e.g., number of
procedures).

 Results: We found that patients with laparoscopic
surgery saved ~0.46 days of hospital stay, but paid $3641 more compared to patients
with open surgery.

Conclusions: Surgeons prefer to use the technologically
advanced laparoscopic appendectomy  (80% of
patients). Our analysis shows that the cost-benefit of laparoscopic
appendectomy is marginal.  Hence, for making
a fully informed decision, patients should be provided with both clinical and
cost comparison data.

Keywords

open appendectomy, laparoscopic appendectomy, pediatric patient, economic cost, regression, cross-sectional analysis

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