Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan
Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan
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DOI：
10.2176/nmc.oa.2019-0139
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发表时间：
2020-01-01
影响因子：
1.9
通讯作者：
Sairyo, Koichi
中科院分区：
文献类型：
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作者：
Manabe, Hiroaki;Tezuka, Fumitake;Sairyo, Koichi
对于完全内窥镜腰椎间盘切除术，操作成本也很重要，因为昂贵的设备是必要的。我们调查了全内窥镜手术所需的手术设备的操作成本以及手术过程的报销费用。回顾分析295例经孔入路全鼻内窥镜手术的临床资料。我们计算了内窥镜等设备和手术器械(如摘核夹钳、高速钻杆和双极钳)的损坏频率和单位购买价，并检查了以日元为单位的手术成本与每个病例的手术费用。内窥镜损坏七次，以旧换新和购买新内窥镜需要支付(原文如此)76万英镑。抓取钳的总破损次数为58次，单位收购价为11.6万美元。因此，295个案例总共需要(原文如此)12,020,000英镑，计算出的伴随设备损坏的运营成本为(原文如此)每箱40,000英镑。此外，每个病例术中使用一次性双极钳和高速钻杆需要约118,000(原文如此)。因此，对于一个病例，计算出总共(原文如此)158,000从日本厚生劳动省规定的每例(原文如此)303,900的手术补偿费用中用于购买设备。微创手术给患者带来了极大的好处；然而，最终对医院利润的贡献很小，可能还不够。为了解决这一问题，应该降低手术设备的成本和/或提高全鼻内窥镜手术的手术报销费用。
For full-endoscopic lumbar discectomy, operating costs are also important because expensive equipment are necessary. We surveyed the operating costs of surgical equipment necessary for full-endoscopic surgery together with surgical procedure reimbursement fees. A total of 295 cases of full-endoscopic surgery via a transforaminal approach were retrospectively analyzed. We calculated the frequency of damage and the unit purchase price of devices such as endoscopes, and surgical instruments such as grasping forceps for nucleotomy, high-speed drill bar, and bipolar forceps, and examined the operating costs in Japanese yen against the procedure fee per case. Endoscope breakage occurred seven times, and a payment of (sic)760,000 was necessary for trade-in and purchase of a new endoscope. The total breakage number of grasping forceps was 58, and the purchase price per unit was (sic)116,000. Therefore, a total of (sic)12,020,000 was required for the 295 cases, and the calculated operating cost that accompanies equipment breakage was (sic)40,000 per case. In addition, about (sic)118,000 was required for disposable bipolar forceps and high-speed drill bar to be used intraoperatively for each case. Thus, for one case it is calculated that total (sic)158,000 is utilized for equipment from the surgical reimbursement fee per case specified by the Japanese Ministry of Health being (sic)303,900. Minimally invasive procedures provide great benefit to patients; however, the eventual contribution to hospital profits is small and may not be sufficient. To resolve this issue, the cost of surgical equipment should be lowered and/or the surgical reimbursement fee of the full-endoscopic surgery should be raised.