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.