Mazouni Traki, Bokri Emna, Azzouz Faouzi, Sammoud Skander, Hammami Nadia, Hasni Nesrine
Department of pharmacy, National Institute of Neurology Mongi-Ben Hamida.
National Institute of Neurology Mongi-Ben Hamida.
Tunis Med. 2023 Nov 5;101(11):805-809.
The management of intracranial aneurysms has evolved in the recent years, and endovascular coiling has become the first treatment option in many countries. In Tunisia, this neuroendovascular treatment meets a progressive but slow development, slowed down, by the economic component.
This study aimed to evaluate the global cost of endovascular treatment of cerebral aneurysms and determine the factors influencing the variation of direct medical cost.
A prospective study including patients who underwent interventional neuroradiology procedures for intracranial aneurysms between March 2019 and June 2019. Total cost (direct medical and non medical cost) was assessed using the micro-costing method. Statistical analysis (descriptive followed by a multivariate analysis) was performed by PSPP software with a p-value< 0.05 considered statistically significant.
Twenty-nine patients were included (mean age 54±14 years). The average overall cost of treatment was 15 877 DT (5 081€), ranging from 8 005 DT (2 562 €) to 36 325 DT (11 624 €). The average cost of medical devices used during the procedure was 13 548 DT (4 335 €) which represents 85.3% of the total cost. The direct medical cost was particularly influenced by aneurysm's and neck's size, and by the total cost of coils.
The medical devices used during the procedure greatly influenced the direct medical cost of the management of intracranial aneurysms.
近年来，颅内动脉瘤的治疗方法不断发展，血管内栓塞术在许多国家已成为首选治疗方案。在突尼斯，这种神经血管内治疗方法虽有进展，但发展缓慢，受到经济因素的制约。
本研究旨在评估颅内动脉瘤血管内治疗的总体费用，并确定影响直接医疗费用变化的因素。
一项前瞻性研究，纳入了2019年3月至2019年6月期间接受颅内动脉瘤介入神经放射治疗的患者。采用微观成本核算方法评估总成本（直接医疗成本和非医疗成本）。使用PSPP软件进行统计分析（先进行描述性分析，然后进行多变量分析），p值<0.05被认为具有统计学意义。
纳入29例患者（平均年龄54±14岁）。治疗的平均总成本为15877第纳尔（5081欧元），范围从8005第纳尔（2562欧元）到36325第纳尔（11624欧元）。手术过程中使用的医疗器械平均成本为13548第纳尔（4335欧元），占总成本的85.3%。直接医疗成本尤其受到动脉瘤和瘤颈大小以及线圈总成本的影响。
手术过程中使用的医疗器械对颅内动脉瘤治疗的直接医疗成本有很大影响。
