Cost-analysis and rationale for implementing semi-urgent laparoscopic cholecystectomy programs in a public healthcare system.

Abstract

Wait times for elective surgical procedures in publicly funded healthcare systems impede patient well-being and resource efficiency. Patients with gallstone disease requiring semi-urgent intervention are often treated via inpatient emergency pathways due to limited elective surgery access. This study aimed to evaluate the rationale and cost-effectiveness of providing timely outpatient semi-urgent cholecystectomy. We retrospectively reviewed 512 patients with urgent biliary disease (excluding cholecystitis) who underwent surgery between July 2019 and December 2022. The primary outcome was time from booking to operating room; the secondary was the estimated cost of prolonged hospital stays. Patients waited an average of 26.45 hours; 19.1% waited 48 hours or longer, and 6.2% waited 72 hours or more. The associated cost was $405,785 over 40 months. Implementing semi-urgent surgical resources could reduce costs, improve efficiency, and enhance patient quality of life. Future work should involve stakeholders to address barriers and facilitators in Canada.