Cost-effectiveness Analysis of Per-abdominal and Laparoscopic Cholecystectomy

Cholelithiasis is one of the major problems which need cholecystectomy. Laparoscopic cholecystectomy is a newer technique. But there is a need to evaluate the cost-effectiveness of per-abdominal and laparoscopic method from patients perspective. The study was performed to assess the cost-effectiveness of per-abdominal and laparoscopic cholecystectomy.
Materials and Methods:
This cross sectional study in two sample situations was conducted among 90 purposively selected cholecystectomy patients of which 60 patients underwent laparoscopic cholecystectomy (LC) and 30 patients underwent per-abdominal cholecystectomy (PAC) from three tertiary level government hospitals of Dhaka, Bangladesh at the time of their discharge through face to face interview using a semi-structured questionnaire and checklist. The study found average age 45.33(13.63) and 41.75(13.39) years in PAC and LC respectively. Average monthly income was less in the PAC group Tk.23200.00(12374.61) than LC Tk.24925.00(12166.86). Average duration of suffering from cholelithiasis was 9.50(8.68) months in PAC group and 12.43(17.49) months in LC group. Average hospital stay was 13.97(6.88) days in PAC group while it was 12.02(6.66) days in LC group. Average treatment cost was little higher Tk.21927.407795.89 in LC group than Tk.21466.306261.42 in the PAC group. Both direct cost and indirect cost were also higher in LC group (Tk.18668.305965.67 and Tk.3661.324229.85) than in PAC group (Tk.18228.004624.75 and Tk.3350.004124.58). But these differences were not statistically significant. In both groups treatment cost significantly increased with duration of hospitalization (correlation, p<0.01). Cure rate was significantly high in LC group (94.4%) than in PAC group (86.7%) (χ2, p<0.05).
This study revealed LC method is cost-effective than PAC method. Total treatment cost in LC can be reduced by minimizing hospital cost, laboratory cost and securing the income of the patients which enhance the economic load.