A prospective cost analysis of laparoscopic cholecystectomy.

BACKGROUND

In order to improve the value of laparoscopic cholecystectomy (LC), we completed a prospective micro-cost analysis at a large, multispecialty referral hospital.

METHODS

After a line-item cost database had been established, the following cost data were retrieved over a 1-year period (May 1993 through May 1994): operating room (OR), radiology, pharmacy, anesthesia supplies, recovery room, and hospital room. OR cost data was further divided into costs for room-staff, room setup, radiology, plus disposable and nondisposable equipment. Sixty uncomplicated LC cases were collected (30 cases each for 2 surgeons to examine the surgeon variable).

RESULTS

Sixty percent of the hospital costs occurred in the OR. Disposable laparoscopic equipment accounted for 17% of the total hospital costs and 28% of the OR costs. Staff charges in the OR (cost estimated by the hospital using minutes in the LC room) represented 24% and 41%, respectively, of the above costs to the hospital.

CONCLUSIONS

The areas in which hospitals and surgeons can improve the surgical value package (ie, decrease costs while maintaining quality) are in disposable equipment and efficient minimization of in-the-room time.