Cost analysis of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy and the risk factors for their increased cost in a public insurance health care system - Single centre study.
Eur J Surg Oncol
; 46(4 Pt A): 607-612, 2020 04.
Article
em En
| MEDLINE
| ID: mdl-31982207
ABSTRACT
INTRODUCTION:
This study aimed to evaluate the costs of CRS and HIPEC and treatment of the related postoperative complications in the public healthcare system. We also aimed to identify the risk factors that increase the cost of CRS and HIPEC. MATERIALS ANDMETHODS:
We retrospectively evaluated 80 patients who underwent CRS and HIPEC between February 2016 and November 2018 in the Department of Surgery, University Hospital of Olomouc, Czech Republic. Intraoperative factors and postoperative complications were assessed. The treatment cost included the surgery, hospital stay, intensive care unit (ICU) admission, pharmaceutical charges including medication, hospital supplies, pathology, imaging, and allied healthcare services.RESULTS:
The postoperative morbidity rate was 50%, and the mortality rate was 2.5%. The mean length of hospitalisation and ICU admission was 15.44 ± 8.43 and 6.15 ± 4.12 for all 80 patients and 10.73 ± 2.93 and 3.73 ± 1.32, respectively, for 40 patients without complications, and 20.15 ± 13.93 and 8.58 ± 6.92, respectively, for 40 patients with complications. The total treatment cost reached 606,358, but the total reimbursement was 262,931; thus, the CRS and HIPEC profit margin was -343,427. Multivariate analysis showed that blood loss ≥1.000 ml (p = 0.03) and grade I-V Clavien-Dindo complications (p < 0.001) were independently associated with increased costs.CONCLUSION:
The Czech public health insurance system does not fully compensate for the costs of CRS and HIPEC. Hospital losses remain the main limiting factor for further improving these procedures. Furthermore, treatment costs increase with increasing severity of postoperative complications.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Acesso_medicamentos_insumos_estrategicos
/
Promover_ampliacao_atencao_especializada
Contexto em Saúde:
1_ASSA2030
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6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Peritoneais
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Complicações Pós-Operatórias
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Financiamento Governamental
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Procedimentos Cirúrgicos de Citorredução
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Hipertermia Induzida
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Seguro Saúde
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Reembolso de Seguro de Saúde
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Surg Oncol
Ano de publicação:
2020
Tipo de documento:
Article