Impact of laparoscopic versus open surgery on hospital costs for colon cancer: a population-based retrospective cohort study

November 3, 2016 | Journal Article

Authors: Mauro Laudicella , Brendan Walsh , Aruna Munasinghe , Omar Faiz
BMJ Open , Vol. 6, Issue 11, November 2016, e012977

Objective Laparoscopy is increasingly being used as an alternative to open surgery in the treatment of patients with colon cancer. The study objective is to estimate the difference in hospital costs between laparoscopic and open colon cancer surgery.

Design Population-based retrospective cohort study.

Settings All acute hospitals of the National Health System in England.

Population A total of 55 358 patients aged 30 and over with a primary diagnosis of colon cancer admitted for planned (elective) open or laparoscopic major resection between April 2006 and March 2013.

Primary outcomes Inpatient hospital costs during index admission and after 30 and 90 days following the index admission.

Results Propensity score matching was used to create comparable exposed and control groups. The hospital cost of an index admission was estimated to be £1933 (95% CI 1834 to 2027; p<0.01) lower among patients who underwent laparoscopic resection. After including the first unplanned readmission following index admission, laparoscopy was £2107 (95% CI 2000 to 2215; p<0.01) less expensive at 30 days and £2202 (95% CI 2092 to 2316; p<0.01) less expensive at 90 days. The difference in cost was explained by shorter hospital stay and lower readmission rates in patients undergoing minimal access surgery. The use of laparoscopic colon cancer surgery increased 4-fold between 2006 and 2012 resulting in a total cost saving in excess of £29.3 million for the National Health Service (NHS).

Conclusions Laparoscopy is associated with lower hospital costs than open surgery in elective patients with colon cancer suitable for both interventions.

  • Publication Details

    Journal Article

    ESRI Series Number: 201755
    Research Area: Health and Quality of Life
    Date of Publication: November 3, 2016
    Published Online: November 03, 2015
    Publisher: BMJ Publishing Group Ltd.
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    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/


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