March 27, 2015
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Laparoscopic colectomy reduces health care utilization, costs

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Laparoscopic colectomy significantly reduced short- and long-term health care utilization and costs compared with open colectomy, according to recent study data.

“We found that the use of minimally invasive laparoscopic approaches in a select group of patients undergoing colectomy procedures resulted in significantly lower health care costs and resource utilization compared with open surgical approaches,” Conor P. Delaney, MD, PhD, from University Hospitals Case Medical Center in Cleveland, said in a press release. “This may expand access and lower the cost of patient care in the long term.”

To compare utilization and costs of health care resources after laparoscopic vs. open colectomy, Delaney and colleagues performed a retrospective multivariate regression analysis of national health insurance claims data extracted from the Truven Health Analytics MarketScan Commercial Claims and Encounters database. Patients aged 18 to 64 years (n = 4,160) who underwent elective laparoscopic (45.6%) or open colectomy (54.4%) in 2010 were evaluated for health care utilization 90 days and 1 year after surgery, health care costs and days off from work related to utilizing health care resources.

Mean length of stay was 7.36 days for open colectomy vs. 4.48 days for laparoscopic colectomy. Mean net and total payments for laparoscopic colectomy were $23,064 and $24,196, respectively, compared with $29,753 and $31,606 for open colectomy. In the first 90 days after the procedure, open colectomy was associated with an estimated 1.26-fold increase in health care costs ($1,715; 95% CI, 338-2,853), increased health care utilization and more days off from work (estimated 2.78 days; 95% CI, 1.93-3.59). Comparable results were found for 1 year after the procedure, with a 1.18-fold increase (95% CI, 1.04-1.35) in health care costs and a 1.15-fold increase (95% CI, 1.08-1.23) in days off from work compared with laparoscopic colectomy.

“These results reflect the well-documented benefits of laparoscopic surgery, which include faster recovery, less pain and fewer complications,” Delaney said.

“The widespread adoption of minimally invasive surgery has the potential to improve care, help patients and reduce health care costs,” Michael Tarnoff, MD, vice president and chief medical officer of the Covidien Group at Medtronic, said in the release. “The global medical community must come together to more quickly modernize surgery by increasing the rate of [minimally invasive surgery] adoption.” – by Adam Leitenberger

Disclosure: One of the researchers reports he is an employee of Covidien.