Long-term postplacement cost after endovascular aneurysm repair
Long-term postplacement cost after endovascular aneurysm repair
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DOI：
10.1016/j.jvs.2007.03.017
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发表时间：
2007-07-01
影响因子：
4.3
通讯作者：
Sternbergh, W. Charles, III
中科院分区：
文献类型：
--
作者：
Noll, Robert E., Jr.;Tonnessen, Britt H.;Sternbergh, W. Charles, III
背景。先前的研究表明，与血管内动脉瘤修复（EVAR）相关的初始住院费用约为20,000美元。然而，长期监测和二次手术的成本却没有得到很好的描述。1998年12月至2006年6月间，同一家医院共有259名患者接受了颅内动脉瘤EVAR治疗。随访费用计算使用相对价值单位为基础的医院成本核算系统，其中包括部门直接和间接成本。机构间接费用是用换算系数计算的。专业服务的费用由成本收费比决定，门诊访问量用基于时间的公式计算。2006年的费用应用于以前的年度。为了尽量减少与早期学习曲线相关的费用，1995年12月至1998年12月期间最初的50例EVAR患者被排除在外。随访时间< 1年的患者也被排除在外。数据以平均值+/-标准误差表示。结果：136例患者EVAR术后平均随访34.7±1.8个月。每位患者5年的累计费用为11351美元。27例（19.9%）需要二次手术的患者的5年累积费用为31,696美元，而109例未进行二次手术的患者的5年累积费用为3668美元(增加8.6倍，P
Background. Previous studies have demonstrated that the initial hospital cost associated with endovascular aneurysm repair (EVAR) is approximately $20,000. However, the cost of long-term surveillance and secondary procedures is poorly characterized.Methods. Between December 1998 and June 2006, 259 patients underwent EVAR for infrarenal aneurysms at a single institution. Follow-up costs were calculated using a relative value unit based hospital cost accounting system, which incorporates departmental direct and indirect costs. Institutional overhead costs were included using a conversion factor. Costs for professional services were determined by a cost-to-charge ratio, and outpatient visits were calculated with a time-based formula. Year 2006 costs were applied to prior years. To minimize costs associated with the early learning curve, the initial 50 EVAR patients between December 1995 and 1998 were excluded. Patients with < 1 year follow-up were also excluded. Data are expressed as mean +/- standard error.Results: The mean follow-up after EVAR for 136 patients was 34.7 +/- 1.8 months. The cumulative 5-year postplacement cost per patient was $11,351. The 27 patients (19.9%) who required secondary procedures had a 5-year cumulative cost of $31,696 compared with $3668 for 109 patients without secondary procedures (8.6-fold increase, P