Rafeh Saeed, Tara M Connelly, Michael Flanagan, Amy Gillis, Elaf Osman, Paul Ridgway, James O'Riordan, Aidan Manning, Seamus Murphy, Gerrard O'Donoghue
Department of Breast and General Surgery, University Hospital Waterford, Waterford, Ireland.
Department of Colorectal and General Surgery, University Hospital Waterford, Waterford, Ireland.
Surgeon. 2022 Dec;20(6):339-344. doi: 10.1016/j.surge.2021.12.007. Epub 2022 Jan 7.
The increasing cost of cosmetic procedures, long elective waiting times in the public system and affordability of procedures offered abroad has driven the rapid growth of cosmetic tourism. The incidence and cost of patients presenting to the Irish health service with complications related to cosmetic procedures carried out in overseas institutions is largely unknown. This heterogenous group of patients is challenging to identify. Limited data exists for this patient group in the Irish context. We aimed to perform a multicentre audit and cost analysis of patients presenting to Irish health services with complications related to cosmetic procedures performed in overseas institutions over a 2 year period.
Patients presenting to two University Hospitals from March 2019-April 2021 with complications after a cosmetic surgical procedure was performed abroad were studied. The HPO ABF 2020 price list data was used to calculate the inpatient and procedure cost for each subject.
14 (13/92.8% female, mean age 43 ± 11.85 years) patients presented during the study period. Countries of cosmetic operation included: Belgium (6/46.2%), the UK (2/15.4%), Latvia, Turkey, Poland, Lithuania, and Estonia (1 patient/7.7% each country). All required a re-operative procedure. These interventions included: removal of infected implant (n = 1), adjustment or removal of a gastric band (n = 9) and debridement of an infected/necrotic wound (n = 3). Mean length of stay was 9.14 ± 7.48 (range 2-28) days. Five (38.4%) patients required vac dressing. The mean cost of the cohort for the interventional procedure and in-patient stay was €15912.53 (+/- €6388). The sum total of all the costs for the cohort was €231038.60.
Significant costs were associated with prolonged hospital admissions, operative interventions, intravenous antibiotics, VAC dressing application and follow up visits. Complications from procedures performed in overseas institutions account for a significant cost burden to health services in Ireland.
美容手术费用不断上涨、公共医疗系统中漫长的择期等待时间以及国外提供的手术的可承受性,推动了美容旅游的迅速发展。在爱尔兰医疗服务机构中,因在海外机构进行的美容手术而出现并发症的患者的发病率和费用在很大程度上尚不清楚。识别这类异质性患者具有挑战性。在爱尔兰背景下,针对该患者群体的数据有限。我们旨在对在两年期间因在海外机构进行的美容手术而出现并发症并前往爱尔兰医疗服务机构就诊的患者进行多中心审计和成本分析。
研究了2019年3月至2021年4月期间前往两家大学医院就诊、在国外进行美容手术后出现并发症的患者。使用HPO ABF 2020价格列表数据来计算每个受试者的住院和手术费用。
在研究期间,有14名患者(13名/92.8%为女性,平均年龄43±11.85岁)前来就诊。美容手术的国家包括:比利时(6名/46.2%)、英国(2名/15.4%)、拉脱维亚、土耳其、波兰、立陶宛和爱沙尼亚(每个国家1名患者/7.7%)。所有患者都需要再次进行手术。这些干预措施包括:取出感染的植入物(n = 1)、调整或取出胃束带(n = 9)以及对感染/坏死伤口进行清创(n = 3)。平均住院时间为9.14±7.48(范围2 - 28)天。5名(38.4%)患者需要负压伤口治疗敷料。该队列进行介入手术和住院治疗的平均费用为15912.53欧元(±€6388)。该队列的所有费用总计为231038.60欧元。
延长住院时间、手术干预、静脉使用抗生素、应用负压伤口治疗敷料以及随访就诊都产生了巨大费用。在海外机构进行的手术引发的并发症给爱尔兰的医疗服务带来了巨大的成本负担。