中国内镜下黏膜剥离术治疗结直肠病变的成本分析
Cost Analysis of Endoscopic Submucosal Dissection for the Treatment of Colorectal Lesions in China.
作者信息
Cui Ning, Zhao Yu, Yu Honggang
机构信息
Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.
出版信息
Biomed Res Int. 2019 Mar 26;2019:6983896. doi: 10.1155/2019/6983896. eCollection 2019.
AIM
The aim of the study was to evaluate costs associated with colonic endoscopic submucosal dissection (ESD) for treatment of colorectal cancer.
METHODS
The study is a retrospective analysis of data on 395 patients treated by colonic ESD.
RESULTS
The operation, consumable items, and medication accounted for 71% of the total costs for colonic ESD treatment. Medication and consumable items' costs were higher if lesions occurred in the transverse colon and right hemicolon compared to the left hemicolon. Medication, consumable items, and total costs were higher for larger lesions. Lesion numbers and carcinoma were associated with higher medication, consumable items, operation, and total costs. Positive surgical margins and complications of hemorrhage or perforation were positively correlated with higher costs for medication, consumable items, and total costs.
CONCLUSION
Labor costs for doctors and nurses remain low in China. Costs for medication and consumable items were higher for treatment involving the transverse colon or right hemicolon (vs. the left hemicolon), larger lesions, carcinoma, and a positive surgical margin. A benchmark cost estimate for ESD treatment including 4 days of postoperative hospitalization was determined to be approximately 5400 USD.
目的
本研究旨在评估结肠内镜黏膜下剥离术（ESD）治疗结直肠癌的相关费用。
方法
本研究是对395例行结肠ESD治疗患者的数据进行回顾性分析。
结果
手术、耗材及药物占结肠ESD治疗总费用的71%。与左半结肠相比，横结肠和右半结肠出现病变时，药物和耗材费用更高。病变越大，药物、耗材及总费用越高。病变数量和癌症与更高的药物、耗材、手术及总费用相关。手术切缘阳性以及出血或穿孔并发症与更高的药物、耗材及总费用呈正相关。
结论
中国医生和护士的人力成本仍然较低。横结肠或右半结肠（相对于左半结肠）、病变较大、癌症以及手术切缘阳性的治疗中，药物和耗材费用更高。包括术后住院4天的ESD治疗基准成本估计约为5400美元。
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