Abstract
6502 Background: The randomized COST trial revealed no significant differences in clinical or quality-of-life endpoints between LAC and OC for stage I-III colon cancer. We conducted a cost-minimization analysis from a third-party payer perspective to test for differences in costs between procedures from surgery through 2 months of follow-up. Methods: Resource use was collected on all patients, including: inpatient and ICU days, reoperations, surgery and anaesthesia times, use of laparotomy and laparoscopic instruments, cartridges, reusable and disposable trocars, and outpatient visits for surgery-related complications. Professional services by surgeons were valued based on Medicare reimbursement rates; all other unit costs were derived from charges adjusted by ratios-of-costs-to-charges for patients treated at two centers, one academic (A) and one community (C). Results: Among 855 patients, length of stay (mean: 5.5 vs. 6.7 days) was significantly shorter, while operating time was significantly longer (mean: 166 vs. 109 minutes) in the LAC arm. More costly OR supplies were used in the LAC arm. Resource use was otherwise similar between arms. Total costs were either modestly higher (C) or not statistically different (A) depending on the source of unit costs (see Table). Conclusion: Economically, the choice between LAC and OC consists of a tradeoff between higher operative costs and shorter length of stay. The direction and magnitude of the net effect depends on the cost inputs from a given institution, with LAC relatively less expensive in institutions with higher “hotel” costs and less costly operative supplies. Future research should focus on structured peri- and post-operative care to further optimize the care and costs associated with LAC. Costs of LAC versus OC (2006 US$). Costs LAC OC Cost Difference (95% CI) * A C A C A C OR 5,292 (36%) 7,254 (52%) 4,064 (28%) 4,544 (39%) 1,228 (1,150, 1,308) 2,710 (2,616, 2,806) Hospital days 6,098 (41%) 3,651 (26%) 7,393 (51%) 4,427 (38%) −1,295 (−1,842, − 766) −776 (−1,103, −459) Total 14,747 (100%) 13,889 (100%) 14,422 (100%) 11,531 (100%) 32 (−1,009, 1,638) 2,358 (1,605, 3,115) * Bootstrap method No significant financial relationships to disclose.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
