Global hospital and operative costs associated with various ventral cavity procedures: a comprehensive literature review and analysis across regions

J Med Econ. 2019 Nov;22(11):1210-1220. doi: 10.1080/13696998.2019.1661680. Epub 2019 Sep 14.

Abstract

Objectives: The aim of this literature review was to provide a comprehensive report on hospital costs, and cost components, for a range of ventral cavity surgical procedures across three regions of focus: (1) Americas, (2) Europe, Middle East and Africa (EMEA), and (3) Asia-Pacific. Methods: A structured search was performed and utilized a combination of controlled vocabulary (e.g., "Hepatectomy", "Colectomy", "Costs and Cost Analysis") and keywords (e.g. "liver resection", "bowel removal", "economics"). Studies were considered eligible for inclusion if they reported hospital-related costs associated with the procedures of interest. Cost outcomes included operating room (OR) time costs, total OR costs, ward stay costs, total admission costs, OR cost per minute and ward cost per day. All costs were converted to 2018 USD. Results: Total admission costs were observed to be highest in the Americas, with an average cost of $15,791. The average OR time cost per minute was found to vary by region: $24.83 (Americas), $14.29 (Asia-Pacific), and $13.90 (EMEA). A cost-breakdown demonstrated that OR costs typically comprised close to 50%, or more, of hospital admission costs. This review also demonstrates that decreasing OR time by 30 min provides cost savings approximately equivalent to a 1-day reduction in ward time. Conclusion: This literature review provided a comprehensive assessment of hospital costs across various surgical procedures, approaches, and geographical regions. Our findings indicate that novel processes and healthcare technologies that aim to reduce resources such as operating time and hospital stay, can potentially provide resource savings for hospital payers.

Keywords: Cost outcomes; bariatric surgery; colectomy; gastrectomy; hepatectomy; hysterectomy; lobectomy; resection; sleeve gastrectomy; surgery.

Publication types

  • Systematic Review

MeSH terms

  • Digestive System Surgical Procedures / economics*
  • Global Health
  • Hospital Costs / statistics & numerical data*
  • Hospitalization / economics*
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay / economics
  • Operative Time