目的：研究在探討影響腹腔鏡膽囊切除術住院病人總體醫療費用之因素，同時分析在論病例計酬制下，可能影響醫療機構申報費用差額的因素，並以利潤觀點探討主要的相關因素，據以提出腹腔鏡手術住院病人在論病例計酬與DRG制度下醫院經營管理方針。
方法：本文研究採回溯性橫斷研究設計，以高雄某區域教學醫院2003年至2007年間1539位接受腹腔鏡膽囊切除術者為研究樣本，採用病歷查閱方法並結合該研究醫院健保申報費用資料檔，利用複迴歸與對數迴歸模式，在控制各種相關因素之後進行影響病人醫療費用、醫院申報費用差額及利潤之關鍵因素探討。
結果：分析1539位樣本，男性613人、女性926人，平均年齡為54.5歲（標準差14.2歲），主要由門診收治住院，共計有1313人（85.3%），未有手術後死亡個案，平均住院天數為3.79天（標準差為3.13天），平均總醫療費用為42528.1元（標準差17410.0元），未超額申報有1366人（88.8%），超額可核實申報133人（8.6%），超額未核實申報有40人（2.6%），平均申報費用差額為14484.1元（標準差8082.1元）。對總醫療費用呈現顯著相關的因素包括年齡（＞65歲）、手術年度（2004年、2005年、2006年、2007年）、入院來源（急診）、主症狀（其他）、合併疾病（二種以上）、手術後合併症（有）、住院天數（3-6天、≧7天）、申報種類（超額未核實申報、超額可核實申報）。對申報費用差額具有顯著性的因素包括年齡（＞65歲）、手術年度（2004年、2005年、2006年、2007年）、入院來源（急診）、主症狀（其他）、術前貴重儀器檢查（有）、合併疾病（一種以上）、手術後合併症（有）、住院天數（3-6天、≧7天）、醫師年平均手術量（50-99例、≧100例）。顯著影響醫院利潤勝算比之因素包括手術年度（2003年、2004年）、入院來源（急診）、主症狀（其他）、術前貴重儀器檢查（有）、住院天數（3-6天、≧7天）。
結論：在本研究的三條迴歸模式中均有數個顯著影響因素，其中住院天數對醫療費用、申報費用差額與利潤都是一個關鍵的影響因素，因此醫院經營者可以透過適當的方法進行管理，研究結果能提供醫院經營者與同儕適度的參考借鏡。

Objectives: Study wanted to explore the factors that will affect the total medical expense in the patients who receive laparoscopic cholecystectomy (LC). We also to confer the influencing factor that will associate with the difference of reports the expense under the case payment system.
Methods:Retrospective study . Collected from year 2003 to 2007, received LC in a general teaching hospital in Kaohsiung city. We also adopt the chart review and combined with the health insurance expense data to explore the important factors that were associated with total hospitalized expenses, declaration of expense differences, and profits. The methods of multiple linear and logistic regressions were needed.
Results: 1539 subjects, 613 male and 926 female. The average age was 54.4 , and 1313 subjects were hospitalized from outpatient. All subject’s average hospitalized days were 3.79 and medical expenses were 42528.1 dollars. The frequencies of the type of declaration about ‘not exceed’, ‘exceed but actually’, and ‘exceed but no actually’ were 88.8%, 8.6%, and 2.6%, in sequence. The average declaration of expense differences was 14484.1 dollars. The significant factors that were associated with total hospitalized expenses were the age, surgical year, source of hospitalize, major symptom, combine disease, a complication after surgery, hospitalized days, type of declaration. In the other linear regression model, we found the age, surgery year, source of hospitalize, major symptom, high technology examination before surgery, combine disease, a complication after surgery, hospitalized days, and physician’s surgery quantity per year had been statistically significant with the declaration of expense differences. For the odds of hospital’s profits, the significant factors include the surgery year, source of hospitalize, major symptom, high technology examination before surgery, and hospitalized days.
Conclusion: We found a few significant factors that were associated with dependent variable in three regression models in this study. The major factor is hospitalized days that were a stronger influence total hospitalized expenses, declaration of expense differences, and hospital’s profits. The hospital’s superintendent can carry on the management through the appropriate method to control the medical resource consumes.

論文審定書-----------------------------------------------------------------------------i
誌謝--------------------------------------------------------------------------------------ii
中文摘要--------------------------------------------------------------------------------iii
英文摘要--------------------------------------------------------------------------------v
內文目錄--------------------------------------------------------------------------------v
表次--------------------------------------------------------------------------------------vii
圖次--------------------------------------------------------------------------------------vii
第一章 緒論--------------------------------------------------------------------------1
第一節 研究背景-----------------------------------------------------------------1
第二節 研究目的-----------------------------------------------------------------5
第二章 文獻探討--------------------------------------------------------------------6
第一節 膽結石成因及診斷-----------------------------------------------------6
第二節 膽結石的治療與膽囊切除術-----------------------------------------12
第三節 台灣膽囊切除術施行概況--------------------------------------------19
第四節 台灣健保醫療支付制度及對腹腔鏡膽囊切除術的規範--------22
第五節 論病例計酬制對醫療機構經營利潤與行為之影響--------------29
第三章 材料與方法-----------------------------------------------------------------36
第一節 研究設計與研究架構--------------------------------------------------36
第二節 研究對象與資料來源--------------------------------------------------37
第三節 研究變項操作型定義--------------------------------------------------38
第四節 資料處理及統計分析--------------------------------------------------40
第四章 研究結果--------------------------------------------------------------------41
第一節 基本特徵分析-----------------------------------------------------------41
第二節 單因子相關因素分析--------------------------------------------------47
第三節 多變量分析--------------------------------------------------------------59
第五章 討論與建議-----------------------------------------------------------------67
第一節 病人特徵與資源耗用--------------------------------------------------67
第二節 總醫療費用、申報費用差額的影響因素--------------------------70
第三節 論病例計酬腹腔鏡膽囊切除術治療利潤因素--------------------73
第四節 結論與建議--------------------------------------------------------------75
參考文獻--------------------------------------------------------------------------------76
附錄一 本研究病例回顧登錄表--------------------------------------------------88
附錄二 全民健保論病例計酬支付通則-----------------------------------------89
作者簡歷--------------------------------------------------------------------------------91

一、中文部分
中央健康保險局，腹腔鏡膽囊切除術（住院）診療項目要求表，全民健康保險醫療費用支付標準，2010，December 1【線上資料】，來源：http://www.nhi.gov.tw /webdata/webdata.asp?menu=1&menu_id=9&webdata_id=2091&WD_ID=49
王琦、廖梅珍，腹腔鏡卵巢切除術臨床路徑實施之成效，長庚護理雜誌，2001；12（1）：23-30。
行政院衛生署統計室，門、住診主要手術處置統計，98年度全民健康保險統計年報，2010，November 5【線上資料】，來源：http://www.doh.gov.tw/CHT2006/ DM/DM2_2.aspx?now_fod_list_no=11596&class_no=440&level_no=3
行政院衛生署統計室，門、住診主要手術處置統計，97年度全民健康保險統計年報，2009，November 4【線上資料】，來源：http://www.doh.gov.tw/CHT2006/ DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=10912&level_no=3&doc_no=73533
行政院衛生署統計室，門、住診主要手術處置統計，96年度全民健康保險統計年報，2008，November 4【線上資料】，來源：http://www.doh.gov.tw/CHT2006/ DM/DM2_2.aspx?now_fod_list_no=10358&class_no=440&level_no=3
行政院衛生署統計室，門、住診主要手術處置統計，95年度全民健康保險統計年報，2008，July 23【線上資料】，來源：http://www.doh.gov.tw/CHT2006/ DM/DM2_2.aspx?now_fod_list_no=10071&class_no=440&level_no=3
行政院衛生署統計室，門、住診主要手術處置統計，94年度全民健康保險統計年報，2008，July 24【線上資料】，來源：http://www.doh.gov.tw/CHT2006/ DM/DM2_2.aspx?now_fod_list_no=10057&class_no=440&level_no=3
李玉春，支付制度，公共衛生學，華杏，1999a。
李玉春，健康保險支付制度，健康保險，巨流圖書公司，1999b。
李金德，醫師手術量與療效及資源耗用之關係—以腹腔鏡膽囊切除手術為例，私立高雄醫學大學公共衛生研究所未出版碩士論文，2003。
林興裕，論病例計酬支付制度對醫療服務使用之影響－以公保白內障手術為例，國立台灣大學公共衛生研究所未出版碩士論文，1996。
阮子凌、藍忠孚，診斷關聯群在我國的引進與發展，全民健康保險雜誌，1999，19：10-3。
洪聖慈，腹腔鏡膽囊切除術醫療品質相關因素探討，國立陽明大學醫務管理研究所未出版碩士論文，2005。
吳昭新，內視鏡和超音波檢查，台灣健康資訊網，1996，May 10 【線上資料】，來源：http://olddoc.tmu.edu.tw/chiaungo/comsense/sonoendo.htm
吳盈瑩，論病例計酬制對醫療服務利用及醫療費用的影響－以全股（膝）關節置換術為例，國立陽明大學醫務管理研究所未出版碩士論文，1999。
吳敬堂、張香蘭、王文彥，臨床路徑之介入對「論病例計酬」案件影響之初步探討－以急性闌尾炎為例，醫院，2000；33（1）：48-53。
姜桂容，談膽石症，台北市藥師公會會刊，1997，15（3）：16-23。
陳怡秀，自然生產論病例計酬制對醫療資源耗用之影響－以三家醫學中心為例，國立台灣大學公共衛生學系未出版碩士論文，1996。
陳偉宏，論病例計酬支付制度對醫院財務績效與經營績效關聯性之研究，國立政治大學會計學系未出版碩士論文，2001。
游志強，論病例計酬制度實施前後醫院選擇病患與申報行為改變之研究，1996∼2004，國立陽明大學衛生福利研究所未出版碩士論文，2006。
黃三桂，論病例計酬制度實施前後對住院日數及醫療費用之影響：以痔瘡或痔瘡併肛門廔管切除術為例，國立陽明大學醫務管理研究所未出版碩士論文，1998。
黃文鴻、李玉春、張鴻仁，全民健保-制度、法規、衝擊，景泰文化事業，1995。
黃金山，健保論病例計酬實施前後醫療資源耗用之分析－以某區域醫院四項外科系論病例計酬為例，中國醫藥學院醫務管理學研究所未出版碩士論文，1998。
黃興睦，腹腔鏡膽囊切除術，臨床醫學，1996，38（1）：9-11。
張佳琪、黃文鴻，健保支付制度對全髖及全膝關節置換手術醫療利用情形之影響，台灣公共衛生雜誌，2001；20（6）：440-50。
張佳祺，論病例計酬支付制度對骨科住院醫療利用情形之影響分析，國立陽明大學衛生福利研究所未出版碩士論文，1998。
張鴻仁，全民健康保險醫療費用支付制度之研究，中華民國行政院經建設委員會，1990。
廖珮茹，論病例計酬制實施下風險分攤管理對醫療資源耗用影響之研究，私立長庚大學管理學研究所碩士論文，2001。
蔡依珍，論病例計酬下醫院選擇病患之行為分析－以腹腔鏡膽囊切除術為例，長榮大學醫務管理學系暨碩士班未出版碩士論文，2004。
黎國洪，膽囊及膽管都有結石怎麼辦？腸胃道疾病與介入性治療網，2006，September 13 【線上資料】，來源：http://www.endoscopy.com.tw/ERCP.asp?id =&sid=66
謝啟瑞、盧瑞芬，醫療經濟學，學富文化事業有限公司，2000。
譚建明，膽結石的成分及解剖的分類，KingNet國家網路醫院，2005，February 5【線上資料】，來源：http://hospital.kingnet.com.tw/essay/essay.html?category= %C2%E5%C3%C4%AFe%AFf&pid =9697
藍忠孚，診斷關聯群在我國之引進與發展，全民健康保險，1999，19：10-13
蘇文斌，全民健保實施論病例計酬對住院醫療資源耗用的影響－以四種腹腔鏡手術為例，逢甲大學保險學系未出版碩士論文，2004。
韓揆，台灣論病例計酬之實施及其變革展望，醫院，2002，l35（2）：15-27。

二、英文部分
Ahmad S, Zafar A, Ahmad M, Ghafoor A, Malik E, Ali A, Qazi UA. Accuracy of surgeon-performed abdominal utrasound for gallstones. J Ayub Med Coll Abbottabad. 2005; 17(1): 70-1.
Akoh JA, Watson WA, Bourne TP. Day case laparoscopic cholecystectomy: Reducing the admission rate. Int J Surg. 2010 Sep 29. [Epub ahead of print]
Ayantunde AA, Agrawal A. Gallstone ileus: diagnosis and management. World J Surg. 2007; 31(6): 1292-7.
Bencini L, Bernini M, Martini F, Rossi M, Farsi M, Boffi B, Miranda E, Moraldi L, Moretti R. Safety of laparoscopic cholecystectomy performed by surgical residents. Chir Ital. 2008; 60(6): 819-24.
Bender JS, Duncan MD, Freeswick PD, Harmon JW, Magnuson TH. Increased laparoscopic experience does not lead to improved results with acute cholecystitis. Am J Surg. 2002; 184(6): 591-4; discussion 594-5.
Berliner HS. Patient dumping--no one wins and we all lose. Am J Public Health. 1988; 78(10): 1279-80.
Bohacek L, Pace DE. Advanced laparoscopic training and outcomes in laparoscopic cholecystectomy. Can J Surg. 2009; 52(4): 291-4.
Busse HJ, Runge C, Nilius R, Zipprich B, Schmidt W, Jäger B. Ultrasound determination of size and calcium content of gallstones. Dtsch Z Verdau Stoffwechselkr. 1982; 42(6): 265-71.
Calland JF, Tanaka K, Foley E, Bovbjerg VE, Markey DW, Blome S, Minasi JS, Hanks JB, Moore MM, Young JS, Jones RS, Schirmer BD, Adams RB. Outpatient laparoscopic cholecystectomy: patient outcomes after implementation of a clinical pathway. Ann Surg. 2001; 233(5): 704-15.
Carter GM, Newhouse JP, Relles DA. How much change in the case mix index is DRG creep? J Health Econ. 1990; 9(4): 411-28.
Chalkoo M, Ahangar S, Durrani AM, Chalkoo S, Shah MJ, Bashir MI. Mini-lap cholecystectomy: modifications and innovations in technique. Int J Surg. 2010; 8(2): 112-7.
Chan KM, Yeh TS, Jan YY, Chen MF. Laparoscopic cholecystectomy for early gallbladder carcinoma: long-term outcome in comparison with conventional open cholecystectomy. Surg Endosc. 2006; 20(12): 1867-71.
Chang TC, Lin MT, Wu MH, Wang MY, Lee PH. Evaluation of early versus delayed laparoscopic cholecystectomy in the treatment of acute cholecystitis. Hepatogastroenterology. 2009a; 56(89): 26-8.
Chahin F, Elias N, Paramesh A, Saba A, Godziachvili V, Silva YJ. The efficacy of laparoscopy in acute cholecystitis. JSLS. 1999; 3(2): 121-5.
Chang WT, Lee KT, Huang MC, Chen JS, Chiang HC, Kuo KK, Chuang SC, Wang SR, Ker CG. The impact of body mass index on laparoscopic cholecystectomy in Taiwan: an oriental experience. J Hepatobiliary Pancreat Surg. 2009b; 16(5): 648-54.
Canto M. Endoscopic ultrasonography and gallstone disease. Gastrointest Endosc. 1996; 43(2 Pt 2): S37-43.
Chen TT, Chang YJ, Ku SL, Chung KP. Statistical process control as a tool for controlling operating room performance: retrospective analysis and benchmarking. J Eval Clin Pract. 2010; 16(5): 905-10.
Ching Li L, Ming-Te H, Soul-Chin C, Po-Li W, Chih-Hsiung W, Weu W. Initial experience of single incision laparoscopic cholecystectomy (with video). Surg Laparosc Endosc Percutan Tech. 2010; 20(4): 243-6.
Cuschieri A, Dubois F, Mouiel J, Mouret P, Becker H, Buess G, Trede M, Troidl H. The European experience with laparoscopic cholecystectomy. Am J Surg. 1991; 161(3): 385-7.
Danzinger RG, Hofmann AF, Schoenfield LJ, Thistle JL. Expansion of decreased bile acid pool and dissolution of gallstones by chenodeoxycholic acid. Gut. 1972a; 13(4): 321.
Danzinger RG, Hofmann AF, Schoenfield LJ, Thistle JL. Dissolution of cholesterol gallstones by chenodeoxycholic acid. N Engl J Med. 1972b; 286(1): 1-8.
Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 1999; 117(3): 632-9.
Feinglass J, Holloway JJ. The initial impact of the Medicare prospective payment system on U.S. health care: a review of the literature. Med Care Rev. 1991; 48(1): 91-115.
Feldstein MS. Hospital cost inflateion: a study of nonprofit price dynamoics. Am Econ Review. 1971; 61(5): 853-72.
Feldstein PJ. The market for hospital services. In: Health Care Economics. 5th ed. New York: Delmar publicshers, 1999.
Ferreira MR, Bennett RL, Gilman SC, Mathewson S, Bennett CL. Diffusion of laparoscopic cholecystectomy in the Veterans Affairs health care system, 1991-1995. Eff Clin Pract. 1999; 2(2): 49-55.
Fisher KS, Reddick EJ, Olsen DO. Laparoscopic cholecystectomy: cost analysis. Surg Laparosc Endosc. 1991; 1(2): 77-81.
Folland S, Goodman AC, Stano M. The role of nonprofit firm. In: The Economics of Health and Health Care. 3th ed. New Jersey: Prentice Hall publicshers, 2001.
Grace PA, Quereshi A, Coleman J, Keane R, McEntee G, Broe P, Osborne H, Bouchier-Hayes D. Reduced postoperative hospitalization after laparoscopic cholecystectomy. Br J Surg. 1991; 78(2): 160-2.
Habu Y, Matsui T, Hayashi K, Watanabe Y, Kawai K. A clinical decision analysis to assess therapeutic modalities for symptomatic gallstones with respect to patient's quality of life and cost-effectiveness. Nippon Shokakibyo Gakkai Zasshi. 1993; 90(11): 2895-908.
Harboe KM, Bardram L. The quality of cholecystectomy in Denmark: outcome and risk factors for 20,307 patients from the national database. Surg Endosc. 2010 Dec 7. [Epub ahead of print]
Hirose M, Imanaka Y, Ishizaki T, Sekimoto M, Harada Y, Kuwabara K, Hayashida K, Oh EH, Evans SE. Profiling hospital performance of laparoscopic cholecystectomy based on the administrative data of four teaching hospitals in Japan. World J Surg. 2005; 29(4): 429-35.
Hjelmqvist B. Complications of laparoscopic cholecystectomy as recorded in the Swedish laparoscopy registry. Eur J Surg Suppl. 2000; (585): 18-21.
Hsia DC, Ahern CA, Ritchie BP, Moscoe LM, Krushat WM. Medicare reimbursement accuracy under the prospective payment system, 1985 to 1988. JAMA. 1992; 268(7): 896-9.
Hsia DC, Krushat WM, Fagan AB, Tebbutt JA, Kusserow RP. Accuracy of diagnostic coding for Medicare patients under the prospective-payment system. N Engl J Med. 1988; 318(6): 352-5.
Hsu CE, Lee KT, Chang CS, Chiu HC, Chao FT, Shi HY. Cholecystectomy prevalence and treatment cost: an 8-year study in Taiwan. Surg Endosc. 2010; 24(12): 3127-33.
Hurley J, Linz D, Swint E. Assessing the effects of the Medicare ProspectivePayment System on the demand for VA inpatient services: an examination of transfers and discharges of problem patients. Health Serv Res. 1990; 25(1 Pt 2): 239-55.
Iida M, Okayama Y, Goto K, Shiraki S, Hoshino M, Takeuchi T. Gallstone classification and analysis of their constituents. Nippon Rinsho. 1993; 51(7): 1718-24.
Jain PK, Hayden JD, Sedman PC, Royston CM, O'Boyle CJ. A prospective study of ambulatory laparoscopic cholecystectomy: training economic, and patient benefits. Surg Endosc. 2005; 19(8): 1082-5.
Kameda H, Ishihara F, Shibata K, Tsukie E. Clinical and nutritional study on gallstone disease in Japan. Jpn J Med. 1984; 23(2): 109-13.
Katz D, Nikfarjam M, Sfakiotaki A, Christophi C. Selective endoscopic cholangiography for the detection of common bile duct stones in patients with cholelithiasis. Endoscopy. 2004; 36(12): 1045-9.
Kaya IO, Ozkardes A, Ozdemir F, Seker G, Tokac M, Ozmen MM. Laparoscopic cholecystectomy in elderly people: does advanced age present any risk for conversion? J Am Geriatr Soc. 2008; 56(5): 962-3.
Kelley JE, Burrus RG, Burns RP, Graham LD, Chandler KE. Safety, efficacy, cost, and morbidity of laparoscopic versus open cholecystectomy: a prospective analysis of 228 consecutive patients. Am Surg. 1993; 59(1): 23-7.
Kim MH, Lim BC, Myung SJ, Lee SK, Ohrr HC, Kim YT, Roe IH, Kim JH, Chung JB, Kim CD, Shim CS, Yun YB, Min YI, Yang US, Kang JK. Epidemiological study on Korean gallstone disease: a nationwide cooperative study. Dig Dis Sci. 1999; 44(8): 1674-83.
Ko CW, Lee SP. Gallstones. In: Yamada T, editor. Text book of Gastroenterology. 5th ed. Wiley-Blackwell; 2008.
Konstadoulakis MM, Antonakis PT, Karatzikos G, Alexakis N, Leandros E. Intraoperative findings and postoperative complications in laparoscopic cholecystectomy: the Greek experience with 5,539 patients in a single center. J Laparoendosc Adv Surg Tech A. 2004; 14(1): 31-6.
Kwon AH, Matsui Y. Laparoscopic cholecystectomy in patients aged 80 years and over. World J Surg. 2006; 30(7): 1204-10.
Lang HC, Chi C, Liu CM. Impact of the case payment reimbursement method on the utilization and costs of laparoscopic cholecystectomy. Health Policy. 2004; 67(2): 195-206.
Lausen M, Ruf G, Seemann W, Farthmann EH. Gallstone ileus--a diagnostic and indications problem--report on 35 patients. Langenbecks Arch Chir. 1986; 367(3): 181-6.
Lee ML. A conspicuous production theory of hospital behavior. South Econ J. 1971; 38: 48-58.
Lee PC, Lai IR, Yu SC. Minilaparoscopic (needlescopic) cholecystectomy: a study of 1,011 cases. Surg Endosc. 2004; 18(10): 1480-4.
Lin HC, Chen CC, Kuo NW. A review of the literature on patient dumping. New Taipei J Med. 2002; 4: 145-50.
Lin HC, Kao S, Tang CH, Yang MC, Lee HS. Factors contributing to patient dumping in Taiwan. Health Policy. 2006; 77(1): 103-12.
Lin HC, Yang MC, Chen CC, Tang CH. Opinions of hospital administrators toward the prevalence of patient dumping in Taiwan. Chang Gung Med J. 2004a; 27(1): 35-43.
Lin HC, Xirasagar S, Tang CH. Costs per discharge and hospital ownership under prospective payment and cost-based reimbursement systems in Taiwan. Health Policy Plan. 2004b; 19(3): 166-76.
Lowenfels AB, Velema JP. Estimating gallstone incidence from prevalence data. Scand J Gastroenterol. 1992; 27(11): 984-6.
Lyass S, Perry Y, Venturero M, Muggia-Sullam M, Eid A, Durst A, Reissman P. Laparoscopic cholecystectomy: what does affect the outcome? A retrospective multifactorial regression analysis. Surg Endosc. 2000; 14: 661-5.
Mack MJ. Minimally invasive and robotic surgery. JAMA. 2001; 285(5): 568-72.
Massarweh NN, Legner VJ, Symons RG, McCormick WC, Flum DR. Impact of advancing age on abdominal surgical outcome. Arch Surg. 2009; 144(12): 1108-1114.
Maxwell JG, Tyler BA, Rutledge R, Brinker CC, Maxwell BG, Covington DL. Cholecystectomy in patients aged 80 and older. Am J Surg. 1998; 176(6): 627-31.
McIntyre RC Jr, Zoeter MA, Weil KC, Cohen MM. A comparison of outcome and cost of open vs. laparoscopic cholecystectomy. J Laparoendosc Surg. 1992; 2(3): 143-8.
McMahon AJ, Fischbacher CM, Frame SH, MacLeod MC. Impact of laparoscopic cholecystectomy: a population-based study. Lancet. 2000; 356(9242): 1632-7.
Metter EJ, Granville RL, Kussman MJ. The effect of threshold amounts for reporting malpractice payments to the National Practitioner Data Bank: analysis using the closed claims data base of the Office of the Assistant Secretary of Defense (Health Affairs). Mil Med. 1997; 162(4): 257-61.
Müller MF, Stehling MK, Wegmann A. Radiologic and ultrasound detection of gallstones. Ther Umsch. 1993; 50(8): 547-52.
Morgenstern L. Carl Langenbuch and the first cholecystectomy. Surg Endosc. 1992; 6(3): 113-4.
Moser AJ, Abedin MZ, Roslyn JJ. The pathogenesis of gallstone formation. Adv Surg. 1993; 26: 357-86.
Mouret P. How I developed laparoscopic cholecystectomy. Ann Acad Med Singapore. 1996; 25(5): 744-7.
Mowschenson PM. Improving the cost-effectiveness of laparoscopic cholecystectomy. J Laparoendosc Surg. 1993; 3(2): 113-9.
Nenner RP, Imperato PJ, Will TO, Starr H, Soroff HS. Hospital reported complications of laparoscopic cholecystectomy among Medicare and Medicaid patients. J Community Health. 1993; 18(5): 253-60.
Newhouse JP. Toward a thery of nonprofit instituteions: an economic model of a hospital. Am Econ Review. 1970; 60(1): 64-74.
Norton SA, Alderson D. Prospective comparison of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in the detection of bile duct stones. Br J Surg. 1997; 84(10): 1366-9.
Pedersen G, Hoem D, Andrén-Sandberg A. Influence of laparoscopic cholecystectomy on the prevalence of operations for gallstones in Norway. Eur J Surg. 2002; 168(8-9): 464-9.
Perissat J. Laparoscopic cholecystectomy: the European experience. Am J Surg. 1993; 165(4): 444-9.
Pauly MV. Nonprofit firms in medical markets. Am Econ Rev. 1987; 77(2): 257-62.
Pauly MV, Redisch M. The not-for-profit hospital as a physicians’ cooperative. Am Econ Review. 1973; 63(1): 87-99.
Riley G, Lubitz J, Gornick M, Mentnech R, Eggers P, McBean M. Medicare beneficiaries: adverse outcomes after hospitalization for eight procedures. Med Care. 1993; 31(10): 921-49.
Salman B, Yüksel O, Irkörücü O, Akyürek N, Tezcaner T, Doğan I, Erdem O, Tatlicioğlu E. Urgent laparoscopic cholecystectomy is the best management for biliary colic. A prospective randomized study of 75 cases. Dig Surg. 2005; 22(1-2): 95-9.
Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, Goodman C, Gemmen E, Shah S, Avdic A, Rubin R. The burden of selected digestive diseases in the United States. Gastroenterology. 2002; 122(5): 1500-11.
Schiff RL, Ansell DA, Schlosser JE, Idris AH, Morrison A, Whitman S. Transfers to a public hospital. A prospective study of 467 patients. N Engl J Med. 1986; 314(9): 552-7.
Schirmer BD, Dix J. Cost effectiveness of laparoscopic cholecystectomy. J Laparoendosc Surg. 1992; 2(4): 145-50.
Schlesinger M, Dorwart R, Hoover C, Epstein S. The determinants of dumping: a national study of economically motivated transfers involving mental health care. Health Serv Res. 1997; 32(5): 561-90.
Sherigar JM, Irwin GW, Rathore MA, Khan A, Pillow K, Brown MG. Ambulatory laparoscopic cholecystectomy outcomes. JSLS. 2006; 10(4): 473-8.
Scott SJ. The Medicare Prospective Payment System. Am J Occup Ther. 1984; 28(5): 330-4.
Shi HY, Lee KT, Uen YH, Chiu CC, Lee HH. Changing approaches to cholecystectomy in elderly patients: a 10-year retrospective study in Taiwan. World J Surg. 2010; 34(12): 2922-31.
Singhal T, Balakrishnan S, Grandy-Smith S, Hunt J, Asante M, El-Hasani S. Gallstones: best served hot. JSLS. 2006; 10(3): 332-5.
Simpson DJ, Wood AM, Paterson HM, Nixon SJ, Paterson-Brown S. Improved management of acute gallstone disease after regional surgical subspecialization. World J Surg. 2008; 32(12): 2690-4.
Smit JW, van Erpecum KJ, Stolk MF, Geerdink RA, Cluysenaer OJ, Erkelens DW, van Berge Henegouwen GP. Successful dissolution of cholesterol gallstone during treatment with pravastatin. Gastroenterology. 1992; 103(3): 1068-70.
Soper NJ, Barteau JA, Clayman RV, Ashley SW, Dunnegan DL. Comparison of early postoperative results for laparoscopic versus standard open cholecystectomy. Surg Gynecol Obstet. 1992; 174(2): 114-8.
Soria-Aledo V, Pellicer E, Candel-Arenas MF, Flores-Pastor B, Carrasco-Prats M, Miguel-Perelló J, Campillo A, Aguayo-Albasini JL. Evaluation of a clinical pathway for laparoscopic cholecystectomy. Cir Esp. 2005; 77(2): 86-90.
Soria V, Pellicer E, Flores B, Carrasco M, Candel Maria F, Aguayo JL. Evaluation of the clinical pathway for laparoscopic cholecystectomy. Am Surg. 2005; 71(1): 40-5.
Su CH, Huang SM, Lui WY. Extracorporeal shock-wave lithotripsy of gallbladder stones. J Formos Med Assoc. 1992; 91(9): 902-6.
Su HY, Lee WJ. Laparoscopic cholecystectomy in older patients: clinical experience from 56 consecutive patients in a rural community hospital in Taiwan. Surg Laparosc Endosc Percutan Tech. 2009; 19(3): 227-30.
Sugata F, Shimizu M. Retrospective studies on gallstone disappearance (author's transl). Nippon Shokakibyo Gakkai Zasshi. 1974; 71(1): 75-80.
Teerawattananon Y, Mugford M. Is it worth offering a routine laparoscopic cholecystectomy in developing countries? A Thailand case study. Cost Eff Resour Alloc. 2005; 3: 10.
Thistle JL, May GR, Bender CE, Williams HJ, LeRoy AJ, Nelson PE, Peine CJ, Petersen BT, McCullough JE. Dissolution of cholesterol gallbladder stones by methyl tert-butyl ether administered by percutaneous transhepatic catheter. N Engl J Med. 1989; 320(10): 633-9.
Topal B, Peeters G, Verbert A, Penninckx F. Outpatient laparoscopic cholecystectomy: clinical pathway implementation is efficient and cost effective and increases hospital bed capacity. Surg Endosc. 2007; 21(7): 1142-6.
Trotman BW, Soloway RD. Pigment gallstone disease: Summary of the National Institutes of Health--international workshop. Hepatology. 1982; 2(6): 879-84.
Tsai YW, Chuang YC, Huang WF, See LC, Yang CL, Chen PF. The effect of changing reimbursement policies on quality of in-patient care, from fee-for-service to prospective payment. Int J Qual Health Care. 2005; 17(5): 421-6.
Uchiyama K, Takifuji K, Tani M, Onishi H, Yamaue H. Effectiveness of the clinical pathway to decrease length of stay and cost for laparoscopic surgery. Surg Endosc. 2002; 16(11): 1594-7.
Valinsky LJ, Hockey RL, Hobbs MS, Fletcher DR, Pikora TJ, Parsons RW, Tan P. Finding bile duct injuries using record linkage: a validated study of complications following cholecystectomy. J Clin Epidemiol. 1999; 52(9): 893-901.
Wang L, Ker CC, Chen JS, Ko YC. Costand effectiveness assessment of laparoscopic cholecystectomy. Kaohsiung J Med Sci. 1996; 12(3): 150-8.
Wang TH, Yue CH, Wang JT, Lin JT. Endoscopic approaches in the diagnosis of obstructive jaundice--with special reference to endoscopic retrograde cholangiopancreatography. J Formos Med Assoc. 1992; 91(2): 164-7.
Wang YC, Yang HR, Chung PK, Jeng LB, Chen RJ. Role of fundus-first laparoscopic cholecystectomy in the management of acute cholecystitis in elderly patients. J Laparoendosc Adv Surg Tech A. 2006; 16(2): 124-7.
Welling TH, Simeone DM. Gallbladder and Biliary Tract: Anatomy and Structural Anomalies. In: Yamada T, editor. Text book of Gastroenterology. 5th ed. Wiley-Blackwell; 2008.
Wenckert A, Robertson B. The natural course of gallstone disease: eleven-year review of 781 nonoperated cases. Gastroenterology. 1966; 50(3): 376-81.
Willekens I, Verdries D, Ceulemans G, Vandenbroucke F, Delvaux G, de Mey J. Gallstone ileus. JBR-BTR. 2010; 93(1): 4-6.
Wyatt SM, Moy E, Levin RJ, Lawton KB, Witter DM Jr, Valente E Jr, Lala R, Griner PF. Patients transferred to academic medical centers and other hospitals: characteristics, resource use, and outcomes. Acad Med. 1997; 72(10): 921-30.
Yeh CN, Chen MF, Jan YY. Laparoscopic cholecystectomy in 226 cirrhotic patients. Experience of a single center in Taiwan. Surg Endosc. 2002; 16(11): 1583-7.
Young C, Moont M. Routine cholecystocholangiography: a viable alternative during laparoscopic cholecystectomy. Aust N Z J Surg. 1998; 68(6): 425-7.
Zacks SL, Sandler RS, Rutledge R, Brown RS Jr. A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy. Am J Gastroenterol. 2002; 97(2): 334-40.