Ma Liang, Ma Lei, Chen Yu, Jiang Yifeng, Su Qiang, Wang Qian, Zhu Yanhong
School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, P.R. China.
Department of Scientific Research Management, Shanghai General Hospital, Shanghai 200080, P.R. China.
Exp Ther Med. 2019 Mar;17(3):1802-1812. doi: 10.3892/etm.2019.7151. Epub 2019 Jan 4.
The aim of the present study was to compare the in-hospital direct medical costs of patients with pelvic fracture treated with minimally invasive surgery (MIS) or open reduction and internal fixation (ORIF). A retrospective, single-center, cohort, and comparative study was performed. Administrative information and clinical results, in addition to cost data, were collected and analyzed. A cost minimization analysis method was used to evaluate the costs of two different surgical techniques. A total of 128 patients diagnosed with pelvic fracture were included in this study; 62 were treated with MIS and 66 underwent ORIF. No significant difference was observed between the 2 groups in terms of patients' clinical baseline characteristics. The operative time, length of incision, intra-operative blood loss, and post-operative length of stay in the MIS group were significantly different compared with those in the ORIF group. The cost-minimization analysis demonstrated that the cost effectiveness of MIS was better than ORIF as the MIS was associated with a significantly lower total in-hospital direct medical cost ($8,900 vs. $5,786, P=0.032), compared with ORIF. The cost-minimization analysis demonstrated that for similar clinical baseline characteristics as well as outcomes, there were differences in direct hospitalization cost of two surgical techniques, and MIS had a lower cost on average than ORIF.
本研究旨在比较采用微创手术（MIS）或切开复位内固定术（ORIF）治疗的骨盆骨折患者的院内直接医疗费用。进行了一项回顾性、单中心、队列和比较研究。除成本数据外，还收集并分析了管理信息和临床结果。采用成本最小化分析方法评估两种不同手术技术的成本。本研究共纳入128例诊断为骨盆骨折的患者；62例接受了MIS治疗，66例接受了ORIF治疗。两组患者的临床基线特征无显著差异。与ORIF组相比，MIS组的手术时间、切口长度、术中出血量和术后住院时间均有显著差异。成本最小化分析表明，MIS的成本效益优于ORIF，因为与ORIF相比，MIS的院内直接医疗总成本显著更低（8900美元对5786美元，P = 0.032）。成本最小化分析表明，对于具有相似临床基线特征和结果的患者，两种手术技术的直接住院成本存在差异，且MIS的平均成本低于ORIF。
