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Costs of laparoscopic vs abdominal hysterectomy
Title: A randomized trial with a cost-consequence analysis after laparoscopic and abdominal hysterectomy
Author:M. Ellstrom et al.
Address:Guteborg, Sweden
Source:Obstetrics and Gynecology 91 (January)1997: 30-34
Summary:Few reports compare costs associated with laparoscopic surgery vs abdominal surgery from a 'societal viewpoint'. Usually, only the cost of the different procedures is evaluated. In this study, women were randomized prospectively to undergo either laparoscopic (n=71) or abdominal (n=72) surgery. Post operative health status was assessed using łThe Medical Outcome Trust 36 Item Short Form Health Survey Questionnaire.˛ Distinction was made between direct costs (hospital) and indirect costs (loss of production value). Post operative health status improved significantly faster in the patients undergoing a laparoscopic hysterectomy. Direct costs were higher in this group by 1.7%, but indirect costs were 50.3% lower. Overall, patients undergoing a laparoscopic hysterectomy incurred costs that were 23.1% lower than patients undergoing an abdominal hysterectomy. They conclude that laparoscopic hysterectomy does not compromise the health status of the patient and provides substantial financial benefits to society.
Comment: Comparison of techniques still has everything to do with the skill and experience of the operator. While an interesting, possibly important, study from an idealistic point of view, its applicability in the US is, at present, questioned.
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