A single-center comparison of the cost analyses of different volume reduction-therapy methods in the treatment of emphysema

Abstract

ÖzPurpose: The aim of this study was to evaluate and compare preoperative and postoperative one year-cost analyses of endobronchial valve and enbronchial coil practices and volume-reduction surgical methods applied for the purpose of reducing volume in the patients with emphysema. Material and Methods: All the data regarding the oneyear-preoperative and postoperative hospital costs of the patients in our hospital, 11 of whom received an endobronchial valve, 9 of whom received an endobronchial coil and 7 of whom underwent a volume reduction-surgery due to emphysema, were obtained along with the data of the respiratory function test and 6-minute walking test results by accessing into the database of our hospital. Results: The entire research group consisted of 27 patients. Following valve and coil and the volume reduction-surgical intervention, there had been an increase in SFT FEV1% values of the patients with emphysema by 54.0%, 44.4% and 24.6%, respectively, whereas another increase was observed in their six-minute walking distances values by 85.7%, 78.7% and 34.1%, respectively. When the costs of the interventions on emphysema were analyzed, valve ($12943.6) and coil ($11328.9) practices were seen to be almost 5 times more costly than the Volume-reduction surgical treatment ($2444.3). Conclusions:The most economical method in terms of transaction costs is the volume-reduction surgery.Amaç: Amfizem hastalarında volüm küçültme amacıyla uygulanan endobronşial valf, endobronşial coil uygulaması ve volüm küçültücü cerrahi yöntemlerinin işlem öncesi ve işlem sonrası bir yıllık süreçteki maliyet analizleri yapılarak, birbirleri ile karşılaştırması amaçlandı. Gereç ve Yönem: Hastanemizde amfizem nedeni ile endobronşial valf uygulanan 11, endobronşial Coil uygulanan 9 ve volüm küçültücü cerrahi uygulanan 7 hastanın prosedürden önceki bir yıl, prosedür ve prosedür sonrası 1 yıllık süreçte ki tüm hastane maliyetleri, solunum fonksiyon testi ve 6 dakika yürüme testi sonucu verileri hastanemiz veri tabanından girilerek elde edildi. Bulgular: Araştırma grubunun tamamı 27 hasta olup, yaş aralığı 40-72, median yaş 57, yaş ortalaması 57.1 ± standart sapması 8.8 yıldır. valf, coil ve volüm küçültücü cerrahi müdahale sonrasında Amfizem hastalarının; SFT FEV1% değerlerinde sırasıyla %54.0, 44.4 ve 24.6 (total %41.1) artış, 6 MWT değerlerinde sırasıyla %85.7, 78.7 ve 34.1 (total %69.8) artış görülmüştür. Amfizem hastalarına yapılan müdahalelerin maliyeti incelendiğinde, Valf (12943.6 $) ve Coil (11328.9 $)'in Volüm Küçültücü cerrahi (2444.3 $) yönteme göre yaklaşık 5 kat daha pahalı olduğu görülmüştür. Sonuç: İşlem maliyeti olarak en ekonomik metod volüm küçültücü cerrahidir.

Endobronchial valve vs coil for lung volume reduction in emphysema: results from a tertiary care centre in Turkey

“… 37 Simon et al, in their study of the EBC in 2017, reported an increase in FEV1 from 0.5 L to 0.6 L (0.1 L) and a decrease in RV from 6.1 to 5.6.11 Metin et al, reported a 54.0% increase in FEV1 after the valve procedure, and 44% after the coil procedure. 38 In our study, among the patients who underwent EBV, we observed a 380 mL increase in FEV1 ( P <.001), and 270 mL decrease in RV ( P <.001). A signifi-cant improvement was found in each parameter after application.…”