Cost-effectiveness of primary abdominal wall hernia repair in a 364-bed provincial hospital of Spain
| Autor: | J. M. Rodríguez Canales, R. de Miguel Ibañez, S. A. Nahban Al Saied, F. Escribano Sotos, J. Alonso Vallejo, C. Blanco Prieto |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Cost effectiveness medicine.medical_treatment Sedation Abdominal Hernia Cost-Benefit Analysis Conscious Sedation Anesthesia General Anesthesia Spinal Health Services Accessibility Abdominal wall medicine Humans Surgical Wound Infection Local anesthesia Hernia Herniorrhaphy Retrospective Studies Hematoma business.industry General surgery Headache Length of Stay Urinary Retention Hernia repair medicine.disease Surgery Hernia Abdominal medicine.anatomical_structure Cross-Sectional Studies Spain Female medicine.symptom business Abdominal surgery Anesthesia Local |
| Zdroj: | Hernia : the journal of hernias and abdominal wall surgery. 15(4) |
| ISSN: | 1248-9204 |
| Popis: | Primary abdominal hernia is a prevalent condition that weighs heavily on human and financial health-care resources (e.g., 1.12% of the total budget of our hospital in 2008). Tension-free hernioplasty is the standard repair procedure, but the anesthetic technique varies, including local anesthesia with sedation (Lsed), regional (Reg), and general (Gen) anesthesia. As the cost-outcome relation of different anesthetic options has never been examined in our health district, we proposed to identify the most cost-effective anesthetic technique out of three options for primary abdominal hernia repair in terms of clinical outcome and health-care economics in this retrospective review.The study sample of 400 patients with primary abdominal hernia in 2008 underwent tension-free hernioplasty using one of three anesthetic techniques: 74 Lsed, 283 Reg, and 43 Gen. The comparability of outcomes was ensured by dividing the sample into homogeneous groups according to the American Society of Anesthesiologists Physical Status classification (ASA 1 and 2) and adjusting for technical complexity, risk factors, and anatomic location.The clinical outcome of hernioplasty with Lsed was significantly better in terms of shorter hospital stay, lower early- and intermediate-term complication rate, and shorter time to recovery after discharge. The short-term recurrence rate did not differ between groups. The mean cost per hernioplasty procedure waseuro3,270.37 (Lsed),euro4,740.37 (Reg), andeuro7,318.44 (Gen).The cost-effectiveness and incremental cost per patient showed the advantage of hernioplasty with Lsed versus Reg (euro794.59) and Lsed versus Gen (euro704.01), respectively. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink