Costs Lower For Minimally Invasive Surgery Versus Open

Main Category: Public Health
Article Date: 04 Aug 2008 - 3:00 PDT

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Results from a new study that focused on three common surgical procedures- hysterectomy, gallbladder removal and appendectomy - showed that minimally invasive surgery significantly reduced the overall cost of care and shortened hospital stays when compared to the more traditional option of open surgery.

In the current landscape of escalating health care costs, delivering the best possible care must often be balanced with the financial impact. The study was conducted to determine costs associated with minimally invasive surgery versus traditional open surgery, as well as determine the added costs of hospital-acquired infections, a critical challenge facing the health care system. More than 11,000 patients were studied from September 1, 2004 through December 31, 2006 from 22 hospitals across 15 states.

The study was co-authored by Candace Gunnarsson, John A. Rizzo and Louis Hochheiser and was supported by Ethicon Endo-Surgery.

The results clearly showed that minimally invasive surgery was the better economic option, as it reduced the overall cost of care by $1,068 per procedure and shortened hospital stays by 1.58 days when compared with open surgery. Measured separately, the study also concluded that hospital-acquired infections were associated with an average increase of $5,182 in the cost of care of all three procedures. Since the study focused on three common procedures, the findings may indicate the same benefit could apply to other surgeries.

Infection rates were obtained using the Nosocomial Infection Marker (NIM), an algorithm designed by Cardinal Health that monitors and tracks hospital-acquired infection rates for up to 30 days post-discharge. This tool enables a more accurate cost assessment compared to previously published works that relied on charges, which often differ substantially from reimbursement, and data that are significantly older.

"This study differs from previous studies because it uses actual reimbursement data for the three procedures and analyzes a very large data set," said Dr. John A. Rizzo, professor in the departments of preventive medicine and economics at Stony Brook University in Stony Brook, New York. "Additionally, this follows another study published in Surgical Endoscopy, which showed that minimally invasive gallbladder removal and hysterectomy reduced the overall odds of acquiring hospital-acquired infections by more than 50% when compared to open surgery. This suggests that the cost savings of minimally invasive surgery compared to open is even greater than what is indicated in the present study."

The future role of piggyback evaluations will also discussed in Volume 8, Issue 1, of Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.

Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 3,000 clinicians, decision-makers, and researchers worldwide.

ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.

Value in Health Volume 11 Issue 6 - November/December 2008
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http://www.ispor.org