Beheshti Michael V, Meek James
Division of Interventional Radiology, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Division of Interventional Radiology, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
J Vasc Interv Radiol. 2014 Apr;25(4):567-74. doi: 10.1016/j.jvir.2013.10.023. Epub 2014 Jan 21.
To determine the "real cost" of conventional transarterial chemoembolization in the treatment of patients with unresectable hepatocellular carcinoma (HCC).
Comprehensive cost data for performance of conventional transarterial chemoembolization were calculated from a retrospective review of records of 50 consecutive outpatient transarterial chemoembolization procedures in 36 patients with HCC. Costs included labor, equipment, facility acquisition and maintenance, overhead, and administrative costs in a single academic medical center. Hourly rate operational costs for the angiography suite and recovery area were calculated, to which the consumable supply costs were added. Conventional transarterial chemoembolization was defined as selective intrahepatic administration of chemotherapeutic agents (doxorubicin and mitomycin C) emulsified in ethiodized oil (Lipiodol).
The hourly rate to operate an angiography suite at the institution was calculated to be $539/h. Recovery time was calculated at $108/h. Median overall cost of conventional transarterial chemoembolization was $3,269 (range, $2,223-$5,654). This overall cost comprised median room and personnel costs of $763 (range, $404-$1,797), consumable costs of $1,886 (range, $1,134-$4,126), and recovery costs of $378 (range, $162-$864).
The largest contribution (62%) to the real cost of outpatient transarterial chemoembolization comes from the expendable equipment used in the procedure. The angiography suite and personnel costs constitute 25% of the total, and recovery costs constitute 13%. This finding is a change from previous reports in which angiography suite operation was the greatest contributor to cost. Understanding real cost is an essential step in determining the value of the procedure.
确定传统经动脉化疗栓塞术治疗不可切除肝细胞癌（HCC）患者的“实际成本”。
通过回顾性分析36例HCC患者连续50例门诊经动脉化疗栓塞术的记录，计算传统经动脉化疗栓塞术的综合成本数据。成本包括一所学术医疗中心的人工、设备、设施购置与维护、管理费用以及行政成本。计算血管造影室和恢复区的小时运营成本，并加上耗材供应成本。传统经动脉化疗栓塞术定义为在乙碘油（碘油）中乳化的化疗药物（阿霉素和丝裂霉素C）的选择性肝内给药。
该机构血管造影室的小时运营成本计算为539美元/小时。恢复时间的成本计算为108美元/小时。传统经动脉化疗栓塞术的中位总成本为3269美元（范围为2223 - 5654美元）。这一总成本包括中位的房间和人员成本763美元（范围为404 - 1797美元）、耗材成本1886美元（范围为1134 - 4126美元）以及恢复成本378美元（范围为162 - 864美元）。
门诊经动脉化疗栓塞术实际成本的最大贡献（62%）来自该手术中使用的一次性设备。血管造影室和人员成本占总成本的25%，恢复成本占13%。这一发现与之前报道不同，之前报道中血管造影室运营是成本的最大贡献因素。了解实际成本是确定该手术价值的关键一步。
