title: Financial impact in the Italian Health Service of laparoscopic versus laparotomic surgery for the treatment of ovarian cysts.
abstract: To assess the cost of two procedures for the removal of ovarian cysts, 200 pre-menopausal women were recruited for the surgical removal of ovarian cysts by laparoscopy (n = 100) and laparotomy (n = 100) according to case-control criteria. Patients operated by laparoscopy (mean age +/- SD 32.22 +/- 9.98 years) and laparotomy (mean age +/- SD 29.57 +/- 6.62 years) for ovarian cysts (mean diameters +/- SD 4.98 +/- 3.62 and 4.83 +/- 2.78 cm) had a post-surgical hospital stay of 3.12 +/- 0.41 and 7.25 +/- 1.08 days (P < 0.001) respectively. The total rate of complications occurring in patients operated by laparoscopy was 9 versus 53% (P < 0.001) of those operated by laparotomy; body temperature > 38 degrees C was recorded in 52/100 of patients operated by laparotomy versus 6/100 of those operated by laparoscopy. The mean cost for each pure surgical treatment performed by laparoscopy was US $498.17 versus US $642.47 when it was performed by laparotomy (P < 0.001). The laparoscopic surgical approach is more expensive in the first 36 operations, thereafter becoming cheaper. The mean of the entire overall expenditure was US $1142.08 and US $2138.72 for laparoscopy and laparotomy (P < 0.001) respectively. The entire expenditure for laparoscopy is higher than laparotomy only until eight operations. In conclusion, laparoscopy versus laparotomy has resulted in a saving of US $14,429.3 for 100 operations while the saving on entire costs was US $99,664.8.
authors.affiliation: Unit of Special Pelvic Surgery, Operative Laparoscopy and Hysteroscopy, University of Bologna, Bologna, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bulletti
authors.forename: R
authors.initials: R
authors.lastname: Seracchioli
authors.forename: V
authors.initials: V
authors.lastname: Polli
authors.forename: A
authors.initials: A
authors.lastname: Albonetti
authors.forename: S
authors.initials: S
authors.lastname: Rossi
authors.forename: L
authors.initials: L
authors.lastname: Barbieri
authors.forename: A
authors.initials: A
authors.lastname: Callegaro
authors.forename: C
authors.initials: C
authors.lastname: Flamigni
mesh_terms: D000328:Adult; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000191:economics*; D007813:Laparotomy / Q000191:economics*; D007902:Length of Stay; D009313:National Health Programs; D010048:Ovarian Cysts / Q000601:surgery*