Cholecystectomy

Abstract

The impact of our evolving health care system on a commonly performed surgical procedure, cholecystectomy, was assessed in a county-subsidized and private university hospital setting. Although condition on admission, use of resources, and outcome were unchanged in the private setting between 1980 and 1988, significant differences were noted among the largely uninsured patients at the county facility during this same time interval. There was a significant increase in the acuity of illness among patients undergoing cholecystectomy at the county hospital in 1988 as compared with 1980. These data suggest that alterations in reimbursement strategies and allocation of resources are significantly impacting on patient care, particularly in nonprivate health care facilities.

Do patient or hospital demographics predict cholecystectomy outcomes? A nationwide study of 93,578 patients

“…The urban hospitals had a longer LOS, higher charges, and no differences in morbidity and mortality. This is in contrast to one study, which found that, although mortality rates were similar, the morbidity rate of cholecystectomy was higher in the large, private, university hospital than in the urban county hospital primarily serving the indigent population [24]. After we controlled for all other covariates in our analysis, neither size nor urban/rural location of the hospital was associated with an increased risk for complication or death.…”

A “Common” surgery curriculum: Health care delivery and undergraduate surgical education in Australian teaching hospitals

“…Some of these problems are not unique in Australian health care delivery. A study of cholecystectomy in the United States revealed increased use of accident and emergency departments in county hospitals from 1980 to 1988 [15].…”