Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis

Background: Due to the increasing costs of the health system and limited financial resources, healthcare policymakers should apply more cost-effective strategies. This study aimed to compare the cost-effectiveness of laparotomy cholecystectomy with laparoscopy. Methods: This economic evaluation...

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Main Authors: Nayeb fadaei Dehcheshmeh, Hamed Abdollahi, Mohammadhosein Haghighizadeh, Farzad Faraji-Khiavi
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2024-10-01
Series:Health Technology Assessment in Action
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Online Access:https://htainaction.tums.ac.ir/index.php/hta/article/view/301
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author Nayeb fadaei Dehcheshmeh
Hamed Abdollahi
Mohammadhosein Haghighizadeh
Farzad Faraji-Khiavi
author_facet Nayeb fadaei Dehcheshmeh
Hamed Abdollahi
Mohammadhosein Haghighizadeh
Farzad Faraji-Khiavi
author_sort Nayeb fadaei Dehcheshmeh
collection DOAJ
description Background: Due to the increasing costs of the health system and limited financial resources, healthcare policymakers should apply more cost-effective strategies. This study aimed to compare the cost-effectiveness of laparotomy cholecystectomy with laparoscopy. Methods: This economic evaluation was performed on patients with cholecystitis who were candidate for surgery in a private hospital in Ahvaz, in 2021. Data collection tools consisted of 4 parts: 1) demographic information checklist; 2) clinical information checklist; 3) cost checklist and 4) effectiveness assessment tool. We used SPSS22 and STATA14.2 for data analysis. One-way sensitivity analysis and Tornado diagrams were performed using Tree Age software. Results:  The mean total effectiveness score in patients treated with laparoscopy 83.44 (SD = 11.34) was higher than those treated with laparotomy 68.39 (SD = 13.61). This difference was statistically significant in all effectiveness criteria except for postoperative infection dimensions and length of operation (P-value <0.001). The mean cost in patients undergoing laparoscopy was significantly higher than those undergoing laparotomy (481.43 $ VS 459.49 $), but overall laparoscopic treatment (5.77) was more cost-effective than laparotomy (6.71). The cost-effectiveness of the laparoscopic procedure was approximately 1.47 $ per effectiveness unit cheaper than laparotomy, according to the ICER. According to one-way sensitivity analysis, the laparotomy method was still more effective by changing the cost and effectiveness components. Conclusion:  Although laparoscopic cholecystectomy was more expensive than laparotomy cholecystectomy, it was generally more cost-effective. The results of this research may help Iran’s health system policymakers and managers in order to extend laparoscopic cholecystectomy in hospitals.
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spelling doaj-art-da9daf37aa3c476db0e3cc445d803e5b2025-08-20T02:14:02ZengTehran University of Medical SciencesHealth Technology Assessment in Action2645-38352024-10-0184Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysisNayeb fadaei Dehcheshmeh0Hamed Abdollahi1Mohammadhosein Haghighizadeh2Farzad Faraji-Khiavi3ahvaz2Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, IranDepartment of Statistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran. Background: Due to the increasing costs of the health system and limited financial resources, healthcare policymakers should apply more cost-effective strategies. This study aimed to compare the cost-effectiveness of laparotomy cholecystectomy with laparoscopy. Methods: This economic evaluation was performed on patients with cholecystitis who were candidate for surgery in a private hospital in Ahvaz, in 2021. Data collection tools consisted of 4 parts: 1) demographic information checklist; 2) clinical information checklist; 3) cost checklist and 4) effectiveness assessment tool. We used SPSS22 and STATA14.2 for data analysis. One-way sensitivity analysis and Tornado diagrams were performed using Tree Age software. Results:  The mean total effectiveness score in patients treated with laparoscopy 83.44 (SD = 11.34) was higher than those treated with laparotomy 68.39 (SD = 13.61). This difference was statistically significant in all effectiveness criteria except for postoperative infection dimensions and length of operation (P-value <0.001). The mean cost in patients undergoing laparoscopy was significantly higher than those undergoing laparotomy (481.43 $ VS 459.49 $), but overall laparoscopic treatment (5.77) was more cost-effective than laparotomy (6.71). The cost-effectiveness of the laparoscopic procedure was approximately 1.47 $ per effectiveness unit cheaper than laparotomy, according to the ICER. According to one-way sensitivity analysis, the laparotomy method was still more effective by changing the cost and effectiveness components. Conclusion:  Although laparoscopic cholecystectomy was more expensive than laparotomy cholecystectomy, it was generally more cost-effective. The results of this research may help Iran’s health system policymakers and managers in order to extend laparoscopic cholecystectomy in hospitals. https://htainaction.tums.ac.ir/index.php/hta/article/view/301Cholecystectomy, Laparoscopy, Laparotomy, Sensitivity analysis, Cost-effectiveness
spellingShingle Nayeb fadaei Dehcheshmeh
Hamed Abdollahi
Mohammadhosein Haghighizadeh
Farzad Faraji-Khiavi
Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis
Health Technology Assessment in Action
Cholecystectomy, Laparoscopy, Laparotomy, Sensitivity analysis, Cost-effectiveness
title Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis
title_full Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis
title_fullStr Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis
title_full_unstemmed Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis
title_short Laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease: a comparative cost-effectiveness analysis
title_sort laparotomy versus laparoscopy cholecystectomy for surgical treatment in patients with gallstone disease a comparative cost effectiveness analysis
topic Cholecystectomy, Laparoscopy, Laparotomy, Sensitivity analysis, Cost-effectiveness
url https://htainaction.tums.ac.ir/index.php/hta/article/view/301
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