A Cost-Effectiveness Comparison of the Open and Laparoscopic Appendectomies for Pediatric Patients

Objectives: Laparoscopic appendectomy (LA) is preferred to open appendectomy (OA), as it is less invasive. However, it is debatable whether LA is more cost-effective. We compared the cost-benefits of LA with OA, using the entire pediatric inpatient hospital data in USA.Methods: The Kids' Inpatient Database (KID) shows that 51,007 pediatric patients were subjected to laparoscopic appendectomy and 12,668 to open appendectomy during 2010-12 across the USA. This dataset was used to assess the cost-effectiveness of LA and OA, while controlling for the demographic characteristics of patients (e.g. age and gender), their background (e.g., place of residence), and complexity of surgery (e.g., number of procedures). Results: We found that patients with laparoscopic surgery saved ~0.46 days of hospital stay, but paid $3641 more compared to patients with open surgery. Conclusions: Surgeons prefer to use the technologically advanced laparoscopic appendectomy (80% of patients). Our analysis shows that the cost-benefit of laparoscopic appendectomy is marginal. Hence, for making a fully informed decision, patients should be provided with both clinical and cost comparison data.