Surgeon Variability Impacts Costs in Laparoscopic Cholecystectomy: the Volume-Cost Relationship

BACKGROUND: Physician variation in adherence to best practices contributes to the high costs of health care. Understanding surgeon-specific cost variation in common surgical procedures may inform strategies to improve the value of surgical care. METHODS: Laparoscopic cholecystectomies at a single institution were identified over a five-year period and linked to an institutional cost database. Multiple linear regression was used to control for patient-, case-, and hospital- specific factors while assessing the impact of surgeon variability on cost. RESULTS: The final dataset contained 1,686 patients. Higher surgeon volume (reported in tertiles) was associated with decreased costs ($5,354 vs $6,301 vs $7,156, p