Economics of emergency laparoscopic cholecystectomy at an Australian tertiary centre in the post COVID-19 era.

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2024-12-20 DOI:10.1016/j.amjsurg.2024.116158

Raymond Hayler, Sam Hanna, Andrea Boerkamp, Yijun Gao, Sam T Alhayo, Michael L Talbot

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Abstract

Background: Laparoscopic cholecystectomy (LC) is a common operation performed worldwide. Indications include acute cholecystitis (AC), with a trend of increasing complexity post-COVID-19. We aim to evaluate the health expenditure on LC at an Australian tertiary centre.

Methods: A retrospective chart review was performed for all LC between July 1, 2022-June 30, 2023 collecting demographics, costs and wait times and comparisons performed between elective and emergency LC.

Results: 125 patients underwent emergency and 78 elective LC. There was no difference between age, sex or ASA. 67 patients (53.6 %) had emergency LC within their booking priority category. Average cost for emergency LC was $12,689.90 with a median stay of four days, compared to $7181.10 and one day for elective (p < 0.01). Operative related costs were the majority with emergency LC higher ($4866.5, 38.4 % v $3957.6, 55.1 % p = 0.02). The largest cost disparity was nursing costs ($2193.7, 17.3 % v 648.3, 9 % p < 0.01).

Conclusion: Costs are likely driven by access to emergency theatre time and increased length of stay. A semi-emergency theatre model could save costs.

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后 COVID-19 时代澳大利亚三级医疗中心急诊腹腔镜胆囊切除术的经济效益。

背景：腹腔镜胆囊切除术（LC）在世界范围内是一种常见的手术。适应症包括急性胆囊炎（AC），其复杂性在covid -19后呈增加趋势。我们的目标是评估澳大利亚高等教育中心LC的医疗支出。方法：对2022年7月1日至2023年6月30日期间所有LC进行回顾性图表回顾，收集人口统计数据、成本和等待时间，并比较选择性和紧急LC。结果：急诊LC 125例，择期LC 78例。年龄、性别和ASA之间没有差异。67名患者（53.6%）在预约优先类别中有紧急LC。紧急LC的平均费用为12,689.90美元，平均住院时间为4天，而选择性LC的平均费用为7181.10美元，平均住院时间为1天(p结论：费用可能是由进入紧急手术室的时间和住院时间的增加所驱动的。半急救模式可以节省成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.