Venkata Seelamanthula, Mariya Abdullah, Syed- Ehsan Panahi and S. Ratnayake
Caboolture Hospital, Australia
Purpose: Gallstone disease remain to be one of the most frequently encountered clinical presentation to the general surgical unit and hence directly relating to a large expenditure for the public health system. In the era of health care where funding to hospitals places limitations for the ability to provide the best practise, we look at the costs and saving that occur when electing to manage a gall stone disease as an emergency laparoscopic cholecystectomy rather than interval cholecystectomy.
Methodology: As pilot study data was collected over a period of two years in a peripheral hospital of patients who underwent laparoscopic cholecystectomies. The data was categorised according to emergency laparoscopic cholecystectomies, or interval cholecystectomies. Details regarding number of ED presentations, length of hospital stay, time to operation from first diagnosis of gallstone disease were recorded. Analysis of the average cost for elective and emergency laparoscopic cholecystectomies, rate for admission to the surgical ward and cost for ED admissions was then done to compare.
Results: Out of a total of 183 patients surveyed, 110 were managed conservatively and 73 were managed as emergency cases. Emergently managed gallstone disease had an average of 1.10 no: of emergency presentations, they waited an average of 2.13 days to their procedure and length of hospital stay was around 4.62 days. The average cost for these patients where around $15239.15. Compared to the conservatively managed patients who had an average of 1.86 ED presentations, waited an average of 131.68 days to their operation and had hospital stay of 5.55 days. The average cost for a patient to be managed conservatively was $16517.21.
Conclusion: Same-admission emergency laparoscopic cholecystectomy can reduce financial burden to the hospital and is likely to save resources in the long term. This is also likely to enhance the best practise for patients.
Venkata Seelamanthula is a Surgical Registrar at Caboolture Hospital, Queensland, Australia. He is actively involved in teaching medical students. He is a member of the Royal college of Surgeons, Edinburgh. He graduated from Kathmandu Medical college, Nepal. He published his research work in Annals of Surgeons. Presented papers in scientific meetings in Australia and international conferences.
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