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ORIGINAL RESEARCH article

Front. Surg.
Sec. Colorectal and Proctological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1543920

Cost-effectiveness and readmission rates of laparoscopic versus open surgery for colorectal cancer: evidence from the health insurance review and assessment service dataset in South Korea

Provisionally accepted
Sanghyun An Sanghyun An 1Sung Eun Hong Sung Eun Hong 2Moo Hyun Kim Moo Hyun Kim 1Ik Yong Kim Ik Yong Kim 1*
  • 1 Wonju Severance Christian Hospital, Wŏnju, Republic of Korea
  • 2 Health Insurance Review and Assessment Service, Chuncheon, Gangwon, Republic of Korea

The final, formatted version of the article will be published soon.

    We aimed to compare and analyze the cost-effectiveness of laparoscopic versus open colorectal surgery (CRS) for colorectal cancer using health insurance claims data derived from multiple institutions in South Korea as well as the differences in hospital length of stay (LOS) and 30-day readmission rates related to postoperative complications.We retrospectively reviewed the clinical data of patients who underwent curative resection for colorectal cancer between January 1, 2020 and December 31, 2022 using national health insurance claims data in South Korea. We determined the surgical approach based on the presence or absence of treatment material codes specific to laparoscopic surgery, and divided the patients into the laparoscopic-CRS (lap-CRS) and open-CRS groups.Results: A total of 34,779 patients were included (open-CRS: 3,262 patients [9.4%]; lap-CRS: 31,517 patients [90.6%]). The mean LOS was 14.11 and 11.27 days for the open-and lap-CRS groups, respectively (p<0.001). The mean medical costs were 9,163 USD and 8,963 USD in the open-and lap-CRS groups, respectively (p<0.001). A total of 1,192 (3.4%) patients were readmitted within 30 days of discharge, with a rate of 5.4% (176 cases) and 3.2% (1,016 cases) in the open-and lap-CRS groups, respectively (p<0.001). Open surgery, male sex, and rectal surgery were identified as factors that increased medical cost.Discussion: According to this South Korean nationwide population-based study, laparoscopic surgery demonstrated a reduction in LOS, medical costs, and readmission rates compared with open surgery in patients with colorectal cancer.

    Keywords: Colorectal Neoplasms, Colorectal Surgery, Hospital Costs, Hospital readmission, Laparoscopy

    Received: 12 Dec 2024; Accepted: 08 Jan 2025.

    Copyright: © 2025 An, Hong, Kim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ik Yong Kim, Wonju Severance Christian Hospital, Wŏnju, Republic of Korea

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