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01-08-2011 | Original Article

Cost-effectiveness of primary abdominal wall hernia repair in a 364-bed provincial hospital of Spain

Authors: R. de Miguel Ibañez, S. A. Nahban Al Saied, J. Alonso Vallejo, J. M. Rodríguez Canales, C. Blanco Prieto, F. Escribano Sotos

Published in: Hernia | Issue 4/2011

Abstract

Purpose

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.

Methods

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.

Results

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 was €3,270.37 (Lsed), €4,740.37 (Reg), and €7,318.44 (Gen).

Conclusion

The cost-effectiveness and incremental cost per patient showed the advantage of hernioplasty with Lsed versus Reg (€794.59) and Lsed versus Gen (€704.01), respectively.

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Title: Cost-effectiveness of primary abdominal wall hernia repair in a 364-bed provincial hospital of Spain
Authors: R. de Miguel Ibañez
S. A. Nahban Al Saied
J. Alonso Vallejo
J. M. Rodríguez Canales
C. Blanco Prieto
F. Escribano Sotos
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Hernia / Issue 4/2011
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-011-0799-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cost-effectiveness of primary abdominal wall hernia repair in a 364-bed provincial hospital of Spain

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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