What is the cost of endoscopic submucosal dissection (ESD)? A medico-economic study.
United European Gastroenterol J
; 7(1): 138-145, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30788126
ABSTRACT
Introduction:
Endoscopic submucosal dissection (ESD) is the gold-standard treatment for superficial lesions of the digestive tract. No medico-economic study has been conducted in Europe. Material andmethods:
A monocentric study was conducted including all patients undergoing ESD between January 2015 and December 2017. The global cost of hospital stays was measured by microcosting, and revenue was based on the diagnosis-related group (DRG) system. The primary objective was to assess the cost/revenue balance. A medico-economic comparison with surgery was performed as a secondary outcome.Results:
A total of 193 patients were prospectively included. The cost per procedure was 3463.79, subtracted from a 2726.84 revenue, with a deficit of -736.96 per stay. Presence of comorbidities/complications increasing DRG value was the only predictive factor for a positive budgetary balance in a multivariate analysis (odds ratio 49.21, 95% confidence interval 11.3-214.25, p < 0.0001). In comparison with surgery, ESD was associated with shorter length of stay (11 vs 2 days; p < 0.0001) and lower morbidity (28% vs 14%; p = 0.061), lower cost (8960 vs 1770; p < 0.0001).Conclusion:
The ESD cost/revenue balance is negative in 80% of cases. Given the benefits of ESD in terms of patient morbidity and financial savings compared with surgery, the implementation of a specific ESD reimbursement is warranted.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Custos de Cuidados de Saúde
/
Trato Gastrointestinal
/
Ressecção Endoscópica de Mucosa
/
Mucosa
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
United European Gastroenterol J
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
França