PMD13 A REAL-WORLD COST-MINIMIZATION ANALYSIS COMPARING THE USE OF DIFFERENT ENDOSCOPIC STAPLERS IN THORACOSCOPIC LOBECTOMY

Abstract

Public hospitals in China are under increasing pressure to control healthcare expenditure growth. This has led to a tendency to procure consumable medical supplies based on acquisition price. However, procurement decisions should be based on an economic evaluation of the whole episode of care instead. This study aimed to investigate the overall impact of different endoscopic staplers on hospitalization costs of thoracoscopic lobectomy. This study used data from electronic medical records (EMR) of one of the largest research hospitals in Anhui Province. Patients who underwent VATS from 2016 to 2017 were selected. Based on types of stapler and cartridge used, patients were retrospectively grouped into two cohorts. Baseline characteristics of the two cohorts were evaluated to identify any significant differences. Hospitalization cost components were used as input for a cost-minimization analysis (CMA) model to calculate an episodic cost differential between the two cohorts. A probabilistic sensitivity analysis was performed to assess robustness of base case results. Base case analysis showed that lower overall episodic costs were achieved in the cohort with more expensive staplers. The mean episodic cost differential was more than $300. Sensitivity analysis indicated that the cohort with more expensive staplers had lower overall episodic costs in more than 85% of cases. This cost-minimization study has demonstrated that the economic impact of different medical supplies went beyond acquisition costs and extended to the overall hospitalization cost. This signifies that procurement decisions based solely on price may have unintended consequences. Hospital management would benefit from comprehensive value assessments when deciding on procurement strategies for consumable medical supplies.