Medicoeconomic study of microsurgical head and neck reconstructions.
Eur Ann Otorhinolaryngol Head Neck Dis
; 128(3): 121-6, 2011 Jun.
Article
en En
| MEDLINE
| ID: mdl-21420924
ABSTRACT
OBJECTIVES:
The use of microanastomosed free flaps has become essential in the management of head and neck defects following cancer resection or other causes. However, this surgery is under-rated by the French case-mix based rating procedure. The purpose of this study was to evaluate the cost balance of this type of surgery in a patient cohort managed by free flap head and neck reconstruction in a polyvalent adult head and neck surgery department. MATERIAL ANDMETHODS:
This retrospective study was based on 52 patients divided into two groups undergoing either mandibular or nonmandibular reconstruction. Possible prognostic factors were investigated in patients undergoing mandibular reconstruction. Kaplan-Meier survival analysis was also performed for both groups of patients. The Foch Hospital financial department's analytical accounting data for 2006 and 2007 were used to evaluate the costs related to these patients. A senior surgeon retrospectively reviewed the patients' charts with the Medical Informatics physician in order to optimize the choice of diagnosis-related group (DRG).RESULTS:
The mean income generated by mandibular and nonmandibular reconstructions in 2006 and 2007 was 545/day and 526/day for hospitalisation including free flap and 828/day and 818/day for "satellite" hospitalisations for other procedures related to the reconstruction, respectively. After review of the rating by a senior surgeon, in order to optimize the choice of DRG, the mean income received by the hospital could have been improved by +6%.CONCLUSION:
Optimization of procedure and hospital stay rating associated with better collaboration with the Medical Informatics physician are essential in order to continue to provide this major surgery, which is essential for the patient's quality of life. A higher rating of this activity by the French health system is also necessary.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Grupos Diagnósticos Relacionados
/
Costos de Hospital
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Procedimientos de Cirugía Plástica
/
Huesos Faciales
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Neoplasias de Cabeza y Cuello
/
Microcirugia
Tipo de estudio:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur Ann Otorhinolaryngol Head Neck Dis
Año:
2011
Tipo del documento:
Article
País de afiliación:
Francia