Addressing the quality and cost of cholecystectomy at a safety net hospital

Abstract

BackgroundThe aim of this study was to evaluate the effects of safety-net burden on outcomes of a common, urgent operation like cholecystectomy. MethodsWe identified all cholecystectomies performed from 2005 to 2011 in the California State Inpatient Database and separated them into three cohorts based on the performing hospital's safety-net burden. Hierarchical multivariable regression analyses were performed with outcomes including laparoscopy, advanced disease, morbidity, length of hospitalization, and cost. ResultsSafety-net hospitals had similar rates of laparoscopy, overall advanced disease, and post-operative morbidity. Yet, they were able to maintain lower overall costs (cost difference −5592, 95% CI -8928, −2256, p < 0.01), despite having similar lengths of stay. ConclusionSafety-net hospitals performed cholecystectomy with similar rates of laparoscopy and morbidity, while achieving lower costs. Safety-net hospitals may be well equipped to perform common, urgent operations like cholecystectomy.