Cost-Effectiveness Analysis of Endovascular Coiling versus Neurosurgical Clipping for Intracranial Aneurysms in Republic of Korea.
10.5469/neuroint.2016.11.2.86
- Author:
Hyuk Won CHANG
1
;
Shang Hun SHIN
;
Sang Hyun SUH
;
Bum Soo KIM
;
Myung Ho RHO
Author Information
1. Department of Radiology, Keimyung University, School of Medicine & Dongsan Medical Center, Daegu, Korea. hyukwonchang@korea.com
- Publication Type:Original Article
- Keywords:
Intracranial Aneurysm;
Hospital Costs;
Insurance;
Health, Surgical Instruments;
Subarachnoid Hemorrhage;
Retrospective Studies
- MeSH:
Aneurysm;
Cost-Benefit Analysis*;
Costs and Cost Analysis;
Delivery of Health Care;
Health Care Costs;
Hospital Costs;
Insurance;
Insurance, Health;
Intracranial Aneurysm*;
Korea;
Length of Stay;
Republic of Korea*;
Retrospective Studies;
Subarachnoid Hemorrhage
- From:Neurointervention
2016;11(2):86-91
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The International Subarachnoid Aneurysm Trial (ISAT) revealed that in ruptured intracranial aneurysms (RA), endovascular coiling (EC) yields better clinical outcomes than neurosurgical clipping (NC) at 1 year. In unruptured aneurysms (UIA), EC is being increasingly used as an alternative to NC due to patients' preference. There is a lot of difference in treatment cost (EC vs. NC) between countries. There is one recently published study dealing with the comparative cost analysis only in UIAs in South Korea. But it is a hospital-based study. So, the authors performed a nation-wide cost effective comparison in our country. MATERIALS AND METHODS: This study was a retrospective analysis of healthcare big data open systems in Health Insurance Review & Assessment Service (HIRA). Hospital cost data of the recent 5 years (from January 2010 to December 2014) were analyzed according to patients' age and sex and the presence of subarachnoid hemorrhage. RESULTS: When comparing the total hospital costs for NC of a UIA (n=13,756) and EC of a UIA (n=17,666), NC [mean±standard deviation (SD): ￦7,987,179±3,855,029] resulted in significantly lower total hospital costs than EC [￦10,201,645±5,001,626, p<0.0001], although a shorter hospital stay with EC of a UIA [8.6 ±7.4 days] vs. NC [15.0 ±8.3 days, p<0.0001]. When comparing the total hospital costs for NC of a RA (n=7,293) and EC of a RA (n=6,954), NC [￦13,914,993±6,247,914] resulted in significantly lower total hospital costs than EC [￦16,702,446±7,841,141, p<0.0001], although shorter hospital stays for EC of a RA [19.8 ±11.4] vs. NC [23.0 ±10.3, p<0.0001]. CONCLUSION: The total hospital costs for the NC of both UIAs and RAs were found to be lower than those for EC in South Korea.
