Laparoscopic Versus Open Appendectomy: A Cost Analysis for Treatment of Socially-insured Patients in an Urban Medical Center

Introduction: Since its introduction nearly thirty years ago, laparoscopic appendectomy (LA) has gained wide acceptance. We sought to analyze the costs of the LA procedure and to compare these to those resulting from open appendectomy (OA).
Methods and Procedures: A retrospective cohort of subjects undergoing both LA and OA at our institution, a 165-bed urban teaching hospital was generated by searching the appropriate CPT codes for these procedures over the period Jan. 2002 to Jan. 2007. We excluded all subjects with private insurance and included only subjects covered by Medicare and Medicaid. The LA group (n=39) was composed of 24 males (m) and 15 females (f) with a median age (inter-quartile range, IQR) of 31 yrs (22-54); the OA group (n=147) had 122 m/25 f with median (IQR) age of 27 (20-41). Outcome measures were length of stay (LOS), cost to OR, and total cost of hospital stay (THC). Because no outcomes were normally distributed for both LA and OA, non-parametric inferential methods were used. P values (p) presented are two-sided and we set alpha at 0.05.
Results: OR costs were significantly higher in the LA group (all data are in 10^3 US$, K$); LA: median=10.73K$; IQR: 9.03K$ to13.44K$; vs. OA: median=4.91K$; IQR: 4.58K$ to 5.61K$; p


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Program Number: P103

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