1 Jul 2015Article
Long waiting lists and health care spending The example of cholecystectomy
Silvia Palmisano 1Chiara Benvenuto 1Biagio Casagranda 1Chiara Dobrinja 1Giuseppe Piccinni 2Nicolò Manzini 1
Affiliations
Article Info
1 Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
2 Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive, and Emergency Surgery, Aldo Moro, University Medical School, Bari, Italy
Ann. Ital. Chir., 2015, 86(4), 327-332;
Published: 1 Jul 2015
Copyright © 2015 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
AIM: Cholecystectomy is among surgical procedures with the longest waiting list and a significant amount of patients waiting for surgery suffer from symptoms related to complications of cholelithiasis. The aim of this study is to evaluate the economic impact caused by waiting lists. MATERIAL AND METHODS: A retrospective study was performed on patients undergoing intervention of cholecystectomy. 86 patients were included in the study. A comparative analysis was carried out among patients without complications (group A) and patients who faced complications while waiting for surgery, therefore requiring unplanned hospital admissions (group B), and patients who were operated in emergency for complications (group C). RESULTS: The overall cost of health care amounted to 1.849,4 € for each patient of group A, 3.513,2 € for each patient of group B and 2.584,6 € for each patient of group C. Each patient of group B was about 1.9 times more expensive than an asymptomatic one (group A) and about 1.36 times more expensive than one operated in emergency (group C). The conversion rate of the groups was not statistically significant, whereas the length of hospital stays was: patients in group B had longer hospital stays compared to patients in groups A and C. CONCLUSION: Early laparoscopic cholecystectomy for complicated cholelithiasis is the cheapest treatment considering the costs of health care, causing lower social costs related to absence from work and an improved perception of the quality of life.
Keywords
- Cholecystectomy
- Complications
- Medical care costs
- Waiting list