An estimation of resource utilization with the introduction of laparoscopic pelvic lymphadenectomy prior to radical hysterectomy in early cervical carcinoma: A progress report from the Laparoscopic Study Group at the Women's Cancer Center at the University of Minnesota Health Science Center

In an observational study following the primary treatment of cervical carcinoma, financial data was gathered to address hospital and physician costs. This was done as a feasibility study to assess whether such data could be collected. As a corollary, we observed changes in these cost data relative to the implementation of laparoscopic lymphadenectomy in selected cases undergoing radical hysterectomy. Definition of costs were provided by Information Services Department of the University of Minnesota Hospital and Clinic (author W.H.). Twenty-seven apportionment codes were defined as standard categories to identify costs and were defined by patient accounting and assigned to every significant hospital event. Statistically, significant differences were noted in room and board costs, operating room cost, discharge needs, and miscellaneous services. Mean room and board costs were significantly less in those patients undergoing laparoscopic lymphadenectomy followed by a radical hysterectomy (Group B-defined in text). Miscellaneous service costs were also statistically, significantly different. However, with respect to those patients undergoing standard lymphadenectomy followed by radical hysterectomy (Group A), the operating room costs were statistically, significantly less. Overall adjusted hospital costs, which include professional services, were not different between the two groups. The feasibility of collecting data from the University of Minnesota Health System to access costs relative to a specific operative procedure, in this case radical hysterectomy, was evaluated. Significant requirements of time and labor costs were required, however. Timely, on-going assessment of hospital costs relative to hospital procedures would be a laudable goal for future assessments of resource allocation. The implementation of new technology in selected patients, in this case, laparoscopic lymphadenectomy, does not invariably increase cost in this health care system.