Financial implications of laparoscopic hot gallbladder service in a nontertiary District General Hospital

The International Journal of Health Planning and Management
Sayantan BhattacharyaPaula Brereton

Abstract

The service of providing index admission laparoscopic cholecystectomy (IALC), as recommended by NIC guidelines, often falls short in nontertiary centres because of a combination of limited resources and financial constraints. This retrospective study in a single-centre District General Hospital included 50 patients, eligible to undergo IALC, and calculated potential savings from performing IALC on the day of admission by considering admission tariffs, bed, and operating costs. The IALC was provided in 19 patients (38%), with a mean delay from admission to operation of (median) 3 days. Mean surplus tariff was £1421 and £1571 in IALC and non-IALC groups, respectively. Performing immediate IALC (on the day of admission) for acute cholecystitis (AC) is predicted to increase mean surplus tariff to £2132 per patient, raising total predicted annual surplus by £53 000. Immediate IALC is also predicted to reduce waiting time for day-case LC by freeing up 53 day-case slots, attracting additional £95 600 annually, along with freeing up many inpatient bed days. This study demonstrates that reduction of preoperative stay in AC by expediting operations in every eligible patient promises significant surplus revenue. Additional advantages incl...Continue Reading

References

Oct 21, 2006·The Cochrane Database of Systematic Reviews·K S Gurusamy, K Samraj
Mar 10, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Amy M CaoMichael R Cox
Oct 21, 2016·The British Journal of Surgery·A J SuttonUNKNOWN CholeS Study Group and the West Midlands Research Collaborative
Jul 7, 2017·Annals of the Royal College of Surgeons of England·A P NavarroS L Parsons

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Citations

Aug 15, 2019·The Medico-legal Journal·Sayantan BhattacharyaMilind Shrotri
May 18, 2020·BJS Open·G A BassUNKNOWN European Society for Trauma and Emergency Surgery (ESTES) Cohort Studies Group
Oct 3, 2018·ANZ Journal of Surgery·Sayan Bhattacharya

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