J Med Assoc Thai 2010; 93 (7):789

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Establishment the Cost-Effectiveness through Set Criteria of Laparoscopic Cholecystectomy
Ruangsin S Mail, Jaroonrach V , Petpichetchian C , Puttawibul P , Sunpaweravong S , Chewatanagongun S

Objective: To assess the set criteria of laparoscopic cholecystectomy (LC) in reducing the length of hospital stay (LOHS), and
total treatment expenditure.

Material and Method: The measurement outcomes were prospectively analyzed through the medical record, and self
questionnaire of the patients.

Results: During the 1-year trial, a total of 122 patients were scheduled for LC. Among these, 85 cases had met the set criteria
of low risk clients of; both preoperative indicator of a) American Society of Anesthesiologists (ASA) class 1 or 2, and
postoperative indicators of b) no surgical drainage, and c) no immediate complication, while 37 cases were excluded due to
ASA class 3 or 4, and various reasons. Distributed by the duration of hospital stay, the patients were classified in to three
groups; group A was overnight hospital stay, 15 of 85 subjects (17.6%), group B was short hospital stay (within 3 days), 51
of 85 subjects (60.0%), and group C was long hospital stay (more than 3 days), 19 of 85 subjects (22.4%). The mean length
of hospital stay (LOHS) was 24 + 1.61 hours in group A, 55 + 11.16 in group B, and 108 + 21.59 in group C, while the
average total expenditure was 531.22 + 111.09, 665.5 + 133.35 and 812.33 + 158.62, respectively. For the overnight hospital
stay group, the LOHS and the total treatment expenditure was significantly lower the other groups (p < 0.001). The majority
of the overnight hospital stay group had rated the patient satisfaction as excellent.

Conclusion: The set criteria of laparoscopic cholecystectomy (LC) are helpful and establish the cost-effectiveness in terms of
reduction of LOHS and total treatment expenditure.

Keywords: Laparoscopic cholecystectomy, Set criteria, Length of hospital stay

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