No abstract

Laparoscopic appendectomy (LA) is preferred to open appendectomy (OA), as it is less invasive. However, it is debatable whether LA is more cost-effective. We compared the cost-benefits of LA with OA, using the entire pediatric inpatient hospital data in the USA. The Kids' Inpatient Database (KID) shows that 51,007 pediatric patients were subjected to laparoscopic appendectomy and 12,668 to open appendectomy during 2010-12 across the USA. This dataset was used to assess the cost-effectiveness of LA and OA while controlling for the demographic characteristics of patients (e.g. age and gender), their background (e.g., place of residence), and complexity of surgery (e.g., number of procedures). We found that patients with laparoscopic surgery saved ~0.46 days of hospital stay, but paid $3641 more compared to patients with open surgery. Surgeons prefer to use the technologically advanced laparoscopic appendectomy (80% of patients). Our analysis shows that the cost-benefit of laparoscopic appendectomy is marginal. Hence, for making a fully informed decision, patients should be provided with both clinical and cost comparison data.

While it is quite straightforward to determine the factors that satisfy cruise passengers, such as dining, entertainment, etc., it is a challenge to determine their relative importance. A cruise firm with limited resources needs to concentrate its resources chiefly on those aspects of the cruise travel experience that its customers value more. Unfortunately the findings in the academic literature about the relative importance of the determinants of cruise passengers' satisfaction provide little guidance as they rarely converge across studies. We offer an explanation for this lack of convergence among the different studies about the relative importance of determinants. We believe that cruise customers who go to different locations form different market segments, with their own unique preferences. The differences in previous studies are due to the data being collected from different locations. We collect a unique dataset from an online website about cruise reviews, and use it to provide empirical support for our explanations. We find that while all consumers prefer value for money the most, the second most important factor is public rooms for tourists headed to Alsaka, cabins for the ones headed to Mediterranean, and service for the ones headed to Caribbean. The findings of this study would be of value to the management of cruise companies in refining advertising message, provision of different cruise services, etc.