Dassonville Olivier, Bozec Alexandre, Château Yann, Reyt Emile, Devauchelle Bernard, Louis Marie-Yolande, Breton Pierre, Julieron Morbize, Yachouh Jacques, Mallet Yann, Sarini Jérôme, Dolivet Gilles, Schiappa Renaud, Gal Jocelyn, Orlanducci Marie-Helene, Poissonnet Gilles, Chamorey Emmanuel
Head and Neck Surgery, Centre Antoine Lacassagne, Institut Universitaire de la Face et du Cou, Nice, France.
Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189, Nice, France.
Eur Arch Otorhinolaryngol. 2017 Feb;274(2):1103-1111. doi: 10.1007/s00405-016-4360-3. Epub 2016 Oct 27.
Free-flap mandibular reconstruction is a highly specialized procedure associated with severe complications necessitating re-interventions and re-hospitalizations. This surgery is expensive in terms of health workers' time, equipment, medical devices and drugs. Our main objective was to assess the direct hospital cost generated by osseocutaneous free-flap surgery in a multicentric prospective micro-costing study. Direct medical costs evaluated from a hospital perspective were assessed using a micro-costing method from the first consultation with the surgeon until the patient returns home, thus confirming the success or failure of the free-flap procedure. The mean total cost for free-flap intervention was 34,009€ (5151-119,604€), the most expensive item being the duration of hospital bed occupation, representing 30-90% of the total cost. In the event of complications, the mean cost increased by 77.3%, due primarily to hospitalization in ICU and the conventional unit. This surgery is effective and provides good results but remains highly complex and costly.
游离皮瓣下颌骨重建是一种高度专业化的手术，伴有严重并发症，需要再次干预和再次住院治疗。就医护人员的时间、设备、医疗器械和药物而言，这种手术费用高昂。我们的主要目标是在一项多中心前瞻性微观成本核算研究中评估骨皮瓣游离皮瓣手术产生的直接医院成本。从医院角度评估的直接医疗成本采用微观成本核算方法，从首次与外科医生会诊直至患者出院，从而确认游离皮瓣手术的成败。游离皮瓣手术的平均总成本为34,009欧元（5151 - 119,604欧元），最昂贵的项目是住院床位占用时间，占总成本的30 - 90%。如果出现并发症，平均成本会增加77.3%，主要原因是入住重症监护病房和常规病房。这种手术有效且效果良好，但仍然高度复杂且成本高昂。
