COST ANALYSIS OF TWO TYPES OF THE LUMBAR SPINE STABILIZING SURGERY

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Autoři: Martina Caithamlová ¹; Markéta Moláková ¹; Michal Filip ²; Miroslav Barták ³; Ivo Květ ¹; Vladimír Rogalewicz ¹
Působiště autorů: CzechHTA, Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic ¹; Department of Neurosurgery, Tomas Bata Regional Hospital, Zlín, Czech Republic and Department of Rehabilition, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic ²; Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic ³
Vyšlo v časopise: Lékař a technika - Clinician and Technology No. 1, 2019, 49, 21-30
Kategorie: Original research

Souhrn

The study is aimed at quantifying the actual costs related to the MAST (Minimal Access Spine Technique) operative technique with the MIDLF (Midline Lumbar Fusion) instrumentation as compared to the costs related to the classic technique with transpedicular instrumentation complemented with PLIF (Posterior Lumbar Interbody Fusion) in the treatment of a degenerative disc disease in the lumbar spine. The costs were calculated using the Activity-Based Costing method. The total costs for the surgery of one segment amount to CZK 166,371 for MIDLF, and CZK 160,160 for PLIF. The cost difference of CZK 6,210.46 primarily accounts for higher costs associated with separately charged materials consumed in MIDLF. Further, the study pointed out the fact that the actual costs necessary for both operative techniques are underfinanced in terms of reimbursements from the public health insurance system.

Klíčová slova:

spine surgery – MAST – MIDLF – PLIF – costs – Activity-Based Costing

Zdroje

Katz JN. Lumbar Disc Disorders and Low-Back Pain: Socioeconomic Factors and Consequences. JBJS. 2006;88.
Parker SL, Chotai S, Devin CJ, Tetreault L, Mroz TE, Brodke DS, Fehlings MG, McGirt MJ. Bending the Cost Curve-Establishing Value in Spine Surgery. Neurosurgery. 2017;80:S61-9.
Allen RT, Garfin SR. The Economics of Minimally Invasive Spine Surgery The Value Perspective. Spine. 2010;35:S375-82.
Fialova S, Popesko B. Calculations and cost management in Czech hospitals. International Conference on Accounting, Auditing, and Taxation (ICAAT 2014). 2014;145-55.
Zelman WN, McCue MJ, Glick ND. Financial management of health care organizations: an introduction to fundamental tools, concepts, and applications. 3rd ed. Jossey-Bass. San Francisco; 2009.
Folland S, Goodman AC, Stano M. The economics of health and health care. 8th ed. Routledge. New York, NY; 2017.
Oseifuah EK. Activity based costing (ABC) in the public sector: benefits and challenges. Problems and Perspectives in Management. 2014;4:581-8.
Kaplan RS, Haas D. Defining, measuring, and improving value in spine care. Seminars in Spine Surgery. 2018;30:80-3.
Keel G, Savage C, Rafiq M, Mazzocato P. Time-driven activity-based costing in health care: A systematic review of the literature. Health Policy. 2017;121:755‑63.
Fujimori T, Miwa T, Iwasaki M, Oda T. Cost-effectiveness of posterior lumbar interbody fusion in the Japanese universal health insurance system. Journal of Orthopaedic Science. 2018;23:299-303.
Goz V, Weinreb JH, Schwab F, Lafage V, Errico TJ. Comparison of complications, costs, and length of stay of three different lumbar interbody fusion techniques: an analysis of the Nation-wide Inpatient Sample database. Spine Journal. 2014;14:2019-27.
Bydon M, Macki M, Abt NB, Witham TF, Wolinsky JP, Gokaslan ZL, Bydon A, Sciubba DM. The cost-effectiveness of interbody fusions versus posterolateral fusions in 137 patients with lumbar spondylolisthesis. Spine Journal. 2015;15:492-8.
S. Twitchell, Karsy M, Reese J, Guan J, Couldwell WT, Dailey A, Bisson EF. Assessment of cost drivers and cost variation for lumbar interbody fusion procedures using the Value Driven Outcomes database. Neurosurgical Focus. 2018;44.
McGirt MJ, Parker SL, Mummaneni P, Knightly J, Pfortmiller D, Foley K, Asher AL. Is the use of minimally invasive fusion technologies associated with improved outcomes after elective interbody lumbar fusion? Analysis of a nationwide prospective patient-reported outcomes registry. Spine Journal. 2017;17: 922‑32.
Lubelski D, Mihalovich KE, Skelly AC, Fehlings MG, Harrop JS, Mummaneni PV, Wang MY, Steinmetz MP. Is Minimal Access Spine Surgery More Cost-effective Than Conventional Spine Surgery?. Spine. 2014;39:S65‑74.
Vertuani S, Nilsson J, Borgman B, Buseghin G, Leonard C, Assietti R, Quraishi NA. A Cost-Effectiveness Analysis of Minimally Invasive versus Open Surgery Techniques for Lumbar Spinal Fusion in Italy and the United Kingdom. Value in Health. 2015;18:810-6.
Mizuno M, Kuraishi K, Umeda Y, Sano T, Tsuji M, Suzuki H. Midline Lumbar Fusion with Cortical Bone Trajectory Screw. Neurologia Medico-Chirurgica. 2014;54:716-21.
Bielecki M, Kunert P, Prokopienko M, Nowak A, Czernicki T, Marchel A. Midline lumbar fusion using cortical bone trajectory screws. Preliminary report. Videosurgery and Other Mini-invasive Techniques. 2016;11:156-63.
Dabbous B, Brown D, Tsitlakidis A, Arzoglou V. Clinical outcomes during the learning curve of MIDline Lumbar Fusion (MIDLFA (R)) using the cortical bone trajectory. Acta Neurochirurgica. 2016;158:1413-20.
Rodriguez A, Neal MT, Liu A, Somasundaram A, Hsu W, Branch CL. Novel placement of cortical bone trajectory screws in previously instrumented pedicles for adjacent-segment lumbar disease using CT image-guided navigation. Neurosurgical Focus. 2014;36.
Linzer P, Filip M, Jurek P, Salek T, Gajdos M, Jarkovsky J. Comparison of biochemical response between the minimally invasive and standard open posterior lumbar interbody fusion. Neurologia I Neurochirurgia Polska. 2016;50:16-23.
Frolová I. Zlínští neurochirurgové učili polské kolegy novou operační metodu [Neurosurgeons from Zlín taught their Polish colleagues a new surgical method] [Internet]. 2015. Available from: http://zlin.cz.
Medtronic Spinal and Biologics. A Prospective, 5-Year Global Study on MAST™ Minimally Invasive Fusion Procedures for the Treatment of the Degenerative Lumbar Spine (MASTERS-D2). [last updated 2019 Jan 16]. In: ClinicalTrials.gov [Internet]. Bethesda (MD): U.S. National Library of Medicine. 2000. Available from: https://clinicaltrials.gov/ct2/show/NCT026175 63ClinicalTrials.gov Identifier: NCT02617563.
Popesko B, Novák P. Application of ABC method in hospital management. In: Thomas G, Fleaurant C, Panagopoulos T, Chevassus-Lozza E, Strouhal J, editors. Recent researches in economics and management transformation. Proceedings of the 6th IASME/WSEAS International Conference on Economy and Management Transformation (EMT '11); 2011 Nov 17-19; Angers, France. WSEAS Press; 2011. p. 73–78.
Popesko B, Novák P, Tučková Z, Fialová Š, Strouhal J. Kalku-lace nákladů ve zdravotnických organizacích [Cost calculation in healthcare facilities]. Wolters Kluwer. Praha; 2014.