Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis
Laparotomy versus laparoscopy cholecystectomy cost-effectiveness analysis
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Abstract
Background: Due to the increasing costs of the health system and limited financial resources, healthcare policymakers should apply more cost-effective strategies. This study aimed to compare the cost-effectiveness of laparotomy cholecystectomy with laparoscopy.
Methods: This economic evaluation was performed on patients with cholecystitis who were candidate for surgery in a private hospital in Ahvaz, in 2021. Data collection tools consisted of 4 parts: 1) demographic information checklist; 2) clinical information checklist; 3) cost checklist and 4) effectiveness assessment tool. We used SPSS22 and STATA14.2 for data analysis. One-way sensitivity analysis and Tornado diagrams were performed using Tree Age software.
Results: The mean total effectiveness score in patients treated with laparoscopy 83.44 (SD = 11.34) was higher than those treated with laparotomy 68.39 (SD = 13.61). This difference was statistically significant in all effectiveness criteria except for postoperative infection dimensions and length of operation (P-value <0.001). The mean cost in patients undergoing laparoscopy was significantly higher than those undergoing laparotomy (481.43 $ VS 459.49 $), but overall laparoscopic treatment (5.77) was more cost-effective than laparotomy (6.71). The cost-effectiveness of the laparoscopic procedure was approximately 1.47 $ per effectiveness unit cheaper than laparotomy, according to the ICER. According to one-way sensitivity analysis, the laparotomy method was still more effective by changing the cost and effectiveness components.
Conclusion: Although laparoscopic cholecystectomy was more expensive than laparotomy cholecystectomy, it was generally more cost-effective. The results of this research may help Iran’s health system policymakers and managers in order to extend laparoscopic cholecystectomy in hospitals.
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| Issue | Vol 8 No 4 (2024) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v8i4.16986 | |
| Keywords | ||
| Cholecystectomy Laparoscopy Laparotomy Sensitivity analysis Cost-effectiveness | ||
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