A cost-minimisation analysis of inpatient versus day surgery for gynaecological laparoscopy

Table 2 Cost units related to laparoscopic surgery [costs are 2004 Danish kroner (DKK)]

	Cost per unit^a (DKK)	Resource unit
	Cost per unit^a (DKK)	Inpatient	Day surgery
Reception/administration
Secretary	213 kr/h	10 min	10 min
Nurse	232 kr/h	15 min	15 min
Anaesthesia
Anaesthetist	450 kr/h	20 min	20 min
Anaesthesia nurse	232 kr/h	AN time + 15	AN time + 15
Drugs & consumables	200 kr^b	Per patient	Per patient
Operation
Surgeon	294–503 kr/h	OP time + 20 min	OP time + 20 min
Supervisor	294–503 kr/h	OP time + 20 min	OP time + 20 min
Theatre nurse (scrubbed)	232 kr/h	AN time + 20 min	AN time + 20 min
Theatre nurse (not scrubbed)	232 kr/h	AN time + 10 min	AN time + 10 min
Consumables (sutures, swabs etc.)	1,000 kr^b	Per patient	Per patient
Use of operating room & equipment	1,500 kr/h^b	AN time	AN time
Recovery room
Nurse	232 kr/h	0.25*REC time	0.25*REC time
Pain relief	See note^c	As per patient data	As per patient data
Antiemetics	See note^c	As per patient data	As per patient data
Hotel costs	2,000 kr/day^b	Length of stay	Length of stay
Complications
Extended hospital stay	Accounted for in length of hospital stay
Extended observation after surgery	0.25*2000 (1 day patient stayed extra 6 hours)
Later hospital admission	7,000 kr/day
Laparotomy (two inpatients)	No extra costs assumed

AN time minutes from induction of anaesthesia to delivery of patient to recovery room, OP time minutes from first incision to final stitch, REC time minutes spent by patient in recovery room
^aSalary costs were based on gross salary per. August 2004 from national sources; unit cost is monthly salary/126.4 h based on assumption that a working year comprises 52 weeks, each of 37 h; after subtracting 8 weeks for public holidays and holidays (10 days and 6 weeks, respectively) and 15 days for absence due to illness, there are on average 1,517 effective working hours per person per year, or 126.4 working hours per month.
^bAssumptions based on information from local financial officers
^cIndividual patient data were collected on use of Fentanyl (IV), Xefo (IV or tablet), Panodil (supp. or tablet), Vilan (IV or subcut.); Zofran (IV), Dehydrobenzperidol (DHB, IV) and Primperan (IV or supp.) all costed according to national prices, excluding any hospital discounts; disposable equipment and fluids associated with drug administration were assumed to be included in the overall cost per dose