EP.TH.1046Probing the cost variation in Laparoscopic Cholecystectomy using PLICS

Abstract

Abstract Aims This pilot study followed the introduction of PLICS (Patient-Level Information and Costing Systems) in our trust. Data for for Q2 2018 was probed to understand cost variation in procedures and to plan how to utilize this system. Methods Elective laparoscopic cholecystectomy data was extracted, providing costing for each procedure across a number of domains. We established a system to assess the domains with the most variation. We calculated the coefficient of variation (CV) for each domain. CV > 1 was seen as high variation and these domains were probed further to identify causes. Results Domains identified to be of notable variation (CV > 1) were length of stay, pathology test costs, drugs administered, medical staffing costs and pharmacy costs. Domains such as interest costs and device costs appeared to be arbitrary and directed our feedback on how to improve the system. Conclusion We identified variation of costs due to dispensation of drugs unrelated to laparoscopic cholecystectomy which can be easily addressed. Staffing cost variation provided data to drive theatre utilization strategies. Improvements in data capture such as device costs per procedure are imperative to evaluate and change practice for further cost efficiencies. Key statement PLICS is a powerful system to probe procedure costs, variation and drive efficiency. Our combined clinical and management team collaborated to understand the data. To use PLICS to the best advantage the data must be accurate, truly recorded at the patient level and be subject to regular scrutiny.