Cutting Health Care Costs One Appendix at a Time

Study shows parents choose less expensive surgery when given price information upfront

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Sep 11, 2014, 04:01 ET

SALT LAKE CITY, Sept. 11, 2014 /PRNewswire-USNewswire/ -- Consumer price comparison is almost nonexistent in the U.S. health care system, but a new study shows that given the choice between a less costly "open" operation or a pricier laparoscopy for their children's appendicitis, parents were almost twice as likely to choose the open procedure – when they were aware of the cost difference.

The study, published in the September issue of Annals of Surgery online, shows that providing pricing information upfront can influence patient choice of surgical procedures and potentially lead to cost savings in health care, says Eric R. Scaife, M.D., senior author, associate professor of surgery and chief of pediatric surgery at the University of Utah School of Medicine.

Scaife, and his colleagues at the University of Utah and Primary Children's Hospital in Salt Lake City, including first author and surgical resident Katie W. Russell, M.D., conducted the research with 100 patients who were seen for suspected acute, uncomplicated appendicitis at the hospital between July 29, 2012, and Feb. 28, 2013.

The researchers gave 49 children and their parents pricing information showing open surgery – the traditional procedure performed with a scalpel – averaged $2,172 less than laparoscopy at the hospital. The remaining 51 patients were not shown the cost information before being asked to choose which operation they wanted.

A post-surgery survey of patients and parents showed that those who received pricing information chose the open operation 1.8 times more often – 63 percent versus 35 percent – than those who were unaware of the cost differences. Choosing the open operation saved significant costs for materials supplies related to surgery. The only material needed for the open procedure was inexpensive suture, while laparoscopy required ports, staplers, sutures and processing fees. Length of hospital stay and time in the operating room were comparable for each type of surgery.

Total median charges, including operative materials, hospital stay, anesthesia and surgery, averaged $1,554 less for open operations than laparoscopy. Among patients who were exposed to cost information, some of which chose laparoscopy, the average total median expenses were $528 less than the group not told about prices. Health insurance status appeared to play no role in the procedure choice.

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SOURCE University of Utah Health Sciences