There is no consensus about the best treatment (surgery, chemotherapy and percutaneous treatments) for hepatic cystic echinococcosis (CE). Retrospective studies have addressed the pros and cons of each option, but costs of treatments have never been studied extensively. Aim of this paper is to compare the cost of PAIR and conservative surgery for non-complicated echinococcal cysts of the liver in Italy. Materials and Methods. Costs of hospital stay, operating theatre, disposable items, salaries for health personnel and sonograms, were obtained from the S.Matteo Hospital Administration and pharmacy. The institution is a large tertiary care teaching hospital in Lombardy, a region in Northern Italy. Costs of 1-year follow-up were included. The costs were calculated for a 3-day hospital stay for PAIR procedure and 4-day hospital stay for surgery, both without complications. Results and Discussion. The 2006 mean specific cost of a PAIR treatment for a 3-day hospital stay and 1 year follow-up was 2,072 EUR (average exchange rate: 1 EUR = 1.26 USD). Main cost entries were the following: a) hospital stay (net cost): € 1,500 (72.4% of the total cost); b) disposable items (needles, catheters) € 239 (11.5%); c) personnel: € 156 (7.5%); d) drugs (30-days albendazole administration as prophylaxis of secondary echinococcosis): € 72 (3.5%); e) ultrasound scans (paid by patient): € 105 (5.1%). In the same year and same hospital, the specific cost of a surgical conservative intervention and 1-year follow-up was 3,267 EUR. Main cost entries were the following: a) hospital stay (net cost): € 2,000 (61,2% of the total cost); b) operating theatre (2 hours): € 140 (4,3%); c) disposable items: e.g. :Fibrin Glue € 500 (15,3%); d) personnel: € 300 (9,2%); e) pre-operative tests (Labs, ECG, Chest X-ray, anesthesiological evaluation): € 150 (4,6%); f) drugs (30-days albendazole administration as prophylaxis of secondary echinococcosis): € 72 (2,2%); g) ultrasound scans (paid by patient): € 105 (3,2%). Conclusion PAIR is significantly less expensive than conservative surgery for uncomplicated echinococcal cysts of the liver. …………………………………………………………………………………………………………………
Brunetti E., Grisolia A., Battelli G., Alessiani M., Filice C. (2007). PAIR vs conservative surgery for uncomplicated echinococcal cysts: evaluation of costs in Italy.
PAIR vs conservative surgery for uncomplicated echinococcal cysts: evaluation of costs in Italy
BATTELLI, GIORGIO;
2007
Abstract
There is no consensus about the best treatment (surgery, chemotherapy and percutaneous treatments) for hepatic cystic echinococcosis (CE). Retrospective studies have addressed the pros and cons of each option, but costs of treatments have never been studied extensively. Aim of this paper is to compare the cost of PAIR and conservative surgery for non-complicated echinococcal cysts of the liver in Italy. Materials and Methods. Costs of hospital stay, operating theatre, disposable items, salaries for health personnel and sonograms, were obtained from the S.Matteo Hospital Administration and pharmacy. The institution is a large tertiary care teaching hospital in Lombardy, a region in Northern Italy. Costs of 1-year follow-up were included. The costs were calculated for a 3-day hospital stay for PAIR procedure and 4-day hospital stay for surgery, both without complications. Results and Discussion. The 2006 mean specific cost of a PAIR treatment for a 3-day hospital stay and 1 year follow-up was 2,072 EUR (average exchange rate: 1 EUR = 1.26 USD). Main cost entries were the following: a) hospital stay (net cost): € 1,500 (72.4% of the total cost); b) disposable items (needles, catheters) € 239 (11.5%); c) personnel: € 156 (7.5%); d) drugs (30-days albendazole administration as prophylaxis of secondary echinococcosis): € 72 (3.5%); e) ultrasound scans (paid by patient): € 105 (5.1%). In the same year and same hospital, the specific cost of a surgical conservative intervention and 1-year follow-up was 3,267 EUR. Main cost entries were the following: a) hospital stay (net cost): € 2,000 (61,2% of the total cost); b) operating theatre (2 hours): € 140 (4,3%); c) disposable items: e.g. :Fibrin Glue € 500 (15,3%); d) personnel: € 300 (9,2%); e) pre-operative tests (Labs, ECG, Chest X-ray, anesthesiological evaluation): € 150 (4,6%); f) drugs (30-days albendazole administration as prophylaxis of secondary echinococcosis): € 72 (2,2%); g) ultrasound scans (paid by patient): € 105 (3,2%). Conclusion PAIR is significantly less expensive than conservative surgery for uncomplicated echinococcal cysts of the liver. …………………………………………………………………………………………………………………I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
