Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives

Publication date: July 2018
Source:Digestive and Liver Disease, Volume 50, Issue 7
Author(s): Carme Loras, Vicenç Mayor, Fernando Fernández-Bañares, Maria Esteve
IntroductionThe complexity of endoscopy has carried out an increase in cost that has a direct effect on the healthcare systems. However, few studies have analyzed the cost of advanced endoscopic procedures (AEP).ObjectivesTo carry out a calculation of the standard direct costs of AEP, and to make a financial comparison with their surgical alternatives.MethodsCalculation of the standard direct cost in carrying out each procedure. An endoscopist detailed the time, personnel, materials, consumables, recovery room time, stents, pathology and medication used. The cost of surgical procedures was the average cost recorded in the hospital.ResultsThirty-eight AEP were analyzed. The technique showing lowest cost was gastroscopy + APC (€116.57), while that with greatest cost was ERCP with cholangioscopy + stent placement (€5083.65). Some 34.2% of the procedures registered average costs of €1000–2000. In 57% of cases, the endoscopic alternative was 2–5 times more cost-efficient than surgery, in 31% of cases indistinguishable or up to 1.4 times more costly.ConclusionStandard direct cost of the majority of AEP is reported using a methodology that enables easy application in other centers. For the most part, endoscopic procedures are more cost-efficient than the corresponding surgical procedure.