Cost variation and opportunities for cost reduction for laparoscopic cholecystectomy

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We performed 163 laparoscopic cholecystectomies at our institution during the third quarter of 2016. Direct supply cost per case varied from $524 to $1,022 among 14 surgeons. The purpose of this study was to determine the reasons for cost variation between high- and low-cost surgeons and identify opportunities for cost reduction.


Average cost of supplies per case was examined for laparoscopic cholecystectomy during a 6-month period. Two groups were created, with the 4 highest-cost surgeons comprising group A and the 2 lowest-cost surgeons comprising group B. The cost for each item was identified, and utilization was compared between groups.


The average supply cost per case in group A was significantly greater than group B ($930 vs. $518). The difference persisted in subgroup analyses of both inpatients and patients with high American Society of Anesthesiologists scores. Compared with group A, surgeons in group B used reusable instruments more often and tended to choose lower-cost disposables.


Significant variation in direct cost exists between surgeons performing laparoscopic cholecystectomy. Much of the cost difference can be accounted for by a relatively small number of high-cost instruments. We identified areas for cost savings by substituting lesser cost alternatives without compromising the quality of patient care.

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