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- Document type:
- Comparative Study; Journal Article; Article
- Author(s):
- Jacobs, VR; Morrison, JE
- Title:
- Comparison of institutional costs for laparoscopic preperitoneal inguinal hernia versus open repair and its reimbursement in an ambulatory surgery center.
- Abstract:
- OBJECTIVE: To compare institutional costs for open versus laparoscopic inguinal hernia repair and its relationship to reimbursement in an ambulatory surgery center in the United States. METHOD: Analysis of institutional costs in US$ of 2006 for all nonreusables used in a laparoscopic total extraperitoneal (TEP) hernia repair using a polyester mesh compared with open hernia repair using polypropylene mesh. A comparison of the institution's disposable costs related to reimbursement at an ambulatory surgery center in Southeastern United States was performed to identify the most cost-effective procedure for the outpatient facility. RESULTS: As fixed and indirect costs of the ambulatory surgery center are similar for both procedures, a cost difference can only be found in direct disposable costs with that being US$ 235.57 for the procedure-specific disposables in the laparoscopic hernia repair as compared with US$ 117.15 for the open hernia repair. Cost for identical disposables used in both procedures amounted to US$ 32.57. Laparoscopic TEP hernia repair has a higher cost for procedure related disposables versus the open hernia repair at +US$ 118.42 mainly being due to the more costly polyester mesh. A flat rate reimbursement of US$ 1800 for a laparoscopic procedure compared with only US$ 950 for the open procedure minus all disposable cost results in a higher institutional income of +US&$ 731.58 (US$ 1531.86 vs. US$ 800.28), from which other institutional costs can be paid. CONCLUSIONS: Despite marginally higher procedure-related disposable costs for laparoscopic TEP hernia repair, the institutional income is remarkably higher owing to a better reimbursement for this procedure in ambulatory surgery centers. From the institution's point of view, laparoscopic hernia repair is by far the more cost-effective procedure when compared with an open hernia procedure at the present time.
- Journal title abbreviation:
- Surg Laparosc Endosc Percutan Tech
- Year:
- 2008
- Journal volume:
- 18
- Journal issue:
- 1
- Pages contribution:
- 70-4
- Language:
- eng
- Fulltext / DOI:
- doi:10.1097/SLE.0b013e31815a58d7
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/18287988
- Print-ISSN:
- 1530-4515
- TUM Institution:
- Frauenklinik und Poliklinik
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