外科ジャーナル

Operating Room Cost versus Outcome in Elective Colectomy

Abstract

Victor E Pricolo

Objectives: Surgeons and health systems face challenges in achieving healthcare cost containment without compromising patient outcome. This study objective was to correlate operating room costs of elective colectomies with their outcome.

Design: Retrospective observational study. Statistical analysis included t-test, ANOVA and Spearman correlation between continuous variables. Setting: Tertiary care medical center. Patients: 114 consecutive patients who underwent an elective colectomy were analyzed collectively and in subgroups by type of Operation: Laparoscopic right colectomy, Open right colectomy, Laparoscopic left colectomy, Open left colectomy, Open total colectomy/proctectomy, Laparoscopic converted to open colectomy. Operating room cost was calculated as charges for equipment utilized and personnel cost. Main Outcome Measures: Outcome was expressed as a weighted numerical score for each patient, ranging from 0 to 10. The score took into account hospital length of stay, complications, 30-day readmission and mortality

Results: Colectomy cost ranged from $387 to $8262 (mean=$2176 ± 1244). The mean outcome score was 8.01 ± 2.4 (p=0.091). Operating room cost did not correlate with outcome, collectively or per subgroup. Conclusions: Higher operating room expenditures did not achieve a superior outcome for elective colectomy. This preliminary work may prompt further analyses of resource utilization versus outcome in surgical practice.