Prospective cost analysis study of cases of right iliac fossa pain

Introduction: Patients with possible appendicitis comprise a large proportion of acute surgical admissions. There has been no previous study on the cost of these admissions. We aimed to prospectively analyse the cost of managing such a group. Methods: Patients who were admitted with right iliac fossa (RIF) pain from 1st April 2011 to 4th May 2011 were identified prospectively. After discharge, each patients medical records were reviewed with a view to ascertaining the cost of the admission. We collected data on length of stay, number and type of radiological investigations, number and type of blood investigations, medications administered and operations performed. Costs for radiological investigations and bed days were obtained from CASEMIX data. Blood investigation costs were obtained from the relevant laboratory. Medication costs were obtained from the pharmacy department. Operation costs were based on the cost of disposable equipment. Results: 94 patients with RIFs pain were admitted during this period. 62 patients underwent surgery (45 laparoscopic, 17 open). There were 53 appendectomies of which 42 were histologically positive. The average length of stay was 4 days. The total cost was 595,348 (6,300 per patient). The largest cost related to hospital bed-days occupied (522,060). Radiology costs were 3,388. Medication costs were 3,517. Blood test costs were 1,619. Operative costs were 61,632. Histology costs were 3,074. Conclusion: We propose that length of stay should be targeted in order to reduce costs. This study is limited by the difficulty to accurately ascertain the cost of staffing and certain other costs. Conflict of interest: None Disclosures: None.