Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist, Zeist, The Netherlands.
Department of Surgery, Diakonessenhuis Utrecht/Zeist, Room: Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands.
Surg Endosc. 2020 May;34(5):1968-1977. doi: 10.1007/s00464-019-06971-z. Epub 2019 Jul 18.
Single-visit (SV) totally extraperitoneal (TEP) inguinal hernia repair is an efficient service without impairment of safety or complication rate. Data on the economic impact of this approach are rare. The aim of this study was to compare the costs between the SV TEP and the regular TEP in an employed healthy population from a hospital and societal point of view.
Retrospectively collected hospital costs and prospectively collected societal costs were obtained from patients treated between July 2016 and January 2018. Outcome measures consisted of all documented institutional care, productivity loss and medical consumption.
For analysing the hospital costs, a total of 116 SV patients were matched to 116 regular patients. The hospital costs of a mean SV patient were €1148.78 compared to €1242.84 for a regular patient, with a mean difference of €94.06. Prospective analyses of 50 SV patients and 50 regular patients demonstrated higher societal costs for a mean regular patient (€2188.33) compared to a mean SV patient (€1621.44). The mean total cost difference between a SV TEP repair and a regular TEP repair equalled €660.95 corresponding to a 19.3% decrease in costs.
This comprehensive cost-analysis showed that in an employed, healthy population, the SV TEP repair outprices the regular TEP repair, with savings of €660.95 per patient, reflecting a 19.3% decrease in costs. This routing is mainly interesting from a societal point of view as the difference is mainly impacted by a decrease in societal costs.
单次访问(SV)完全腹膜外(TEP)腹股沟疝修补术是一种高效的服务,不会影响安全性或并发症发生率。关于这种方法的经济影响的数据很少。本研究的目的是从医院和社会的角度比较 SV TEP 和常规 TEP 的成本。
从 2016 年 7 月至 2018 年 1 月接受治疗的患者中收集回顾性的医院成本和前瞻性的社会成本。结果测量包括所有记录的机构护理、生产力损失和医疗消费。
为了分析医院成本,共有 116 名 SV 患者与 116 名常规患者相匹配。与常规患者相比,SV 患者的平均医院费用为 1148.78 欧元,而常规患者为 1242.84 欧元,平均差异为 94.06 欧元。对 50 名 SV 患者和 50 名常规患者的前瞻性分析表明,与 SV 患者相比,常规患者的社会成本更高(平均常规患者为 2188.33 欧元,平均 SV 患者为 1621.44 欧元)。SV TEP 修复与常规 TEP 修复之间的平均总费用差异为 660.95 欧元,相当于成本降低了 19.3%。
这项综合成本分析表明,在就业、健康的人群中,SV TEP 修复比常规 TEP 修复更具成本效益,每位患者可节省 660.95 欧元,反映出成本降低了 19.3%。从社会角度来看,这种方案主要是因为社会成本的下降导致了成本的差异。