Addressing the quality and cost of cholecystectomy at a safety net hospital.

BACKGROUND

The aim of this study was to evaluate the effects of safety-net burden on outcomes of a common, urgent operation like cholecystectomy.

METHODS

We identified all cholecystectomies performed from 2005 to 2011 in the California State Inpatient Database and separated them into three cohorts based on the performing hospital's safety-net burden. Hierarchical multivariable regression analyses were performed with outcomes including laparoscopy, advanced disease, morbidity, length of hospitalization, and cost.

RESULTS

Safety-net hospitals had similar rates of laparoscopy, overall advanced disease, and post-operative morbidity. Yet, they were able to maintain lower overall costs (cost difference -5592, 95% CI -8928, -2256, p < 0.01), despite having similar lengths of stay.

CONCLUSION

Safety-net hospitals performed cholecystectomy with similar rates of laparoscopy and morbidity, while achieving lower costs. Safety-net hospitals may be well equipped to perform common, urgent operations like cholecystectomy.