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 : 2025-03-01 Epub 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.