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 WOMENS-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 physici an 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 lymphadenecto my in selected cases undergoing radical hysterectomy. Definition of co sts were provided by Information Services Department of the University of Minnesota Hospital and Clinic (author W.H.). Twenty-seven apportio nment codes were defined as standard categories to identify costs and were defined by patient accounting and assigned to every significant h ospital event. Statistically, significant differences were noted in ro om and board costs, operating room cost, discharge needs, and miscella neous services. Mean room and board costs were significantly less in t hose patients undergoing laparoscopic lymphadenectomy followed by a ra dical hysterectomy (Group B-defined in text). Miscellaneous service co sts were also statistically, significantly different. However, with re spect to those patients undergoing standard lymphadenectomy followed b y radical hysterectomy (Group A), the operating room costs were statis tically, significantly less. Overall adjusted hospital costs, which in clude 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 procedu re, in this case radical hysterectomy, was evaluated. Significant requ irements of time and labor costs were required, however. Timely, on-go ing 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 thi s health care system.