Multicenter prospective micro-costing study evaluating mandibular free-flap reconstruction.
Fiche publication
Date publication
février 2017
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DOLIVET Gilles
Tous les auteurs :
Dassonville O, Bozec A, Château Y, Reyt E, Devauchelle B, Louis MY, Breton P, Julieron M, Yachouh J, Mallet Y, Sarini J, Dolivet G, Schiappa R, Gal J, Orlanducci MH, Poissonnet G, Chamorey E
Lien Pubmed
Résumé
Free-flap mandibular reconstruction is a highly specialized procedure associated with severe complications necessitating re-interventions and re-hospitalizations. This surgery is expensive in terms of health workers' time, equipment, medical devices and drugs. Our main objective was to assess the direct hospital cost generated by osseocutaneous free-flap surgery in a multicentric prospective micro-costing study. Direct medical costs evaluated from a hospital perspective were assessed using a micro-costing method from the first consultation with the surgeon until the patient returns home, thus confirming the success or failure of the free-flap procedure. The mean total cost for free-flap intervention was 34,009€ (5151-119,604€), the most expensive item being the duration of hospital bed occupation, representing 30-90% of the total cost. In the event of complications, the mean cost increased by 77.3%, due primarily to hospitalization in ICU and the conventional unit. This surgery is effective and provides good results but remains highly complex and costly.
Mots clés
Adolescent, Adult, Aged, Female, France, Free Tissue Flaps, economics, Hospital Costs, statistics & numerical data, Hospitalization, economics, Humans, Male, Mandibular Reconstruction, economics, Middle Aged, Prospective Studies, Reoperation, economics, Young Adult
Référence
Eur Arch Otorhinolaryngol. 2017 Feb;274(2):1103-1111