Background and Goal of Study:
Aneurysm of the brain blood vessel has 5% of the population and 1–2% experience an aneurysm rupture. Treatment is carried out surgically or endovascular procedures as more modern, less aggressive but more expensive method in peri-operative time(instalated material: cois and stents). There is a need for economic assessment of the viability of the new method compared to the standard. The aim of this study is to compare the real costs and effects of neurosurgical treatment, compared to the endovascular procedure in patients with intracranial aneurysm.
Materials and Metods:
Our retrospective and descriptive study measured 299 general anesthesia for 200 neurosurgical and 99 endovasculare procedure, for acute bleeding and no bleeding aneurysm at the Institute of Neurosurgery, Clinical Center of Serbia, Belgrade, in 2010. Costs are calculated according to prices Republic Health Insurance of Serbia. Numerical data were computed and analyzed by means of Microsoft Office Excel 2003 and SPSS for Windows.
Anesthesiological controlled time was 453.44 min for general anesthesia without significance for both group. Personnel costs were 41.4 Euro per anesthesia and 1.2 Euro per anesthesia minute for both group. Neurosurgical treatment used clips(the mean = 280 Euro), but costs for endovascular procedure were more expensive(the mean = 3 110 Euro) for one procedure. The mean hospital days were 14,5 for neurosurgical treatment and 11,8 for endovascular procedures.The total cost of embolization was significantly higher than neurosurgical treatment aneurysm.
Conclusions and Discussion:
Duration of treatment (hospital day) the most and other elements to lesser degree have impact on expenses. Anesthesiological work, sophisticated machines and personnel costs of the Therapy Unit are not well worked out methodologically. Other studies suggest that perioperative costs are higher for endovascular procedures that for neurosurgical treatment. The costs of hospital days greater for neurosurgical treatment.The following studies would be The cost-effectiveness analysis. The study would use a Markov model simulations TreeAgePro softer, the time horizon of 10 years. Discounted rates for costs and effects was 5%. The effect of the planned therapy compared to standard, expressed in the form of incremental cost-effect (ICER), a willingness to pay was 1.5 to 3 GDP.
Keywords: economic analysis, neurosurgical anesthesia
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© 2012 European Society of Anaesthesiology