Long waiting lists and health care spending: the example of cholecystectomy.
OBJECTIVE
Cholecystectomy is among surgical procedures with the longest waiting list and a significant amount of patients waiting for surgery suffer from symptoms related to complications of cholelithiasis. The aim of this study is to evaluate the economic impact caused by waiting lists.


METHODS
A retrospective study was performed on patients undergoing intervention of cholecystectomy. 86 patients were included in the study. A comparative analysis was carried out among patients without complications (group A) and patients who faced complications while waiting for surgery, therefore requiring unplanned hospital admissions (group B), and patients who were operated in emergency for complications (group C).


RESULTS
The overall cost of health care amounted to 1.849,4 € for each patient of group A, 3.513,2 € for each patient of group B and 2.584,6 € for each patient of group C. Each patient of group B was about 1.9 times more expensive than an asymptomatic one (group A) and about 1.36 times more expensive than one operated in emergency (group C). The conversion rate of the groups was not statistically significant, whereas the length of hospital stays was: patients in group B had longer hospital stays compared to patients in groups A and C.


CONCLUSIONS
Early laparoscopic cholecystectomy for complicated cholelithiasis is the cheapest treatment considering the costs of health care, causing lower social costs related to absence from work and an improved perception of the quality of life.


BACKGROUND
Cholecystectomy, Complications, Medical care costs, Waiting list.
Silvia
S
Palmisano
Chiara
C
Benvenuto
Biagio
B
Casagranda
Chiara
C
Dobrinja
Giuseppe
G
Piccinni
Nicolò
N
de Manzini
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014850:Waiting Lists; D055815:Young Adult