Cost-effectiveness of inguinal herniorrhaphy at a tertiary care hospital
Journal Title: International Journal of Biomedical Research - Year 2015, Vol 6, Issue 10
Abstract
Background: To determine the cost-effectiveness of elective inguinal herniorrhaphy for various repair methods, and to compare between them in the context of reoperation. Methods: Retrospective review of medical records from patients who underwent elective inguinal herniorrhaphy during the period between January 1998 and June 2014. The incremental cost-effective ratios (ICER) of hernia repairs were calculated by using the primary tissue repair as reference cost. Results: There were 1,415 patients with 1,787 elective inguinal hernia repairs. Of the 1,787 repairs, 91.9% (1,643) were for primary and 8% (144) were for secondary hernias. Tissue repairs were performed in 64.9% (1,159) of all operations, open mesh repairs in 22.3% (399) and laparoscopic mesh repair in 16.7% (229). There were 137 reoperations (7.7% of 1,787), 125 (7.6% of 1,643) for primary repairs and 12 (8.3% of 144) for secondary repairs. Differences in the reoperation rates were greatest for the first 3 years of an operation, after which all the rates tended to converge. According to the Cox regression model, risk factors significantly associated with higher reoperation rates included direct hernias, longer duration of operation, and older age. The average cost of reoperation for tissue repair, open mesh repair, and laparoscopic repair were 10,500 (350 US$), 17,307.00 (576.90 US$), 21,631.00 (721.03 US$) bath, respectively. The incremental cost-effective ratios of primary OM and LAP were 134.11 and 181.12, respectively. The incremental cost-effective ratios of secondary OM and LAP were 91.99 and 139.14, respectively. Conclusions: Open mesh repair seem to be more cost-effective than laparoscopic hernia repair.
Authors and Affiliations
Suthas Horsirimanont, Chumpon Wilasrusmee, Panuwat Lertsithichai, Napaphat Poprom
Keywords
Related Articles
- EP ID EP420021
- DOI 10.7439/ijbr.v6i10.2533
- Views 74
- Downloads 0
Polymorphisms in folate-metabolizing genes as risk factors
Objectives: Down syndrome (DS) may be associated with congenital heart defects (CHD). Folate-metabolizing genes have been suspected as risk factors in DS and in CHD. We investigated the role of methylenetetrahydrofolater...
Correlation between arm span and stature in different age groups-An anthropometric study in population of Rajasthan
Background: The estimation of inter-relationship between arm span and stature has been an important tool in anthropometric measurements. It is found to be of great importance in such cases where direct measurement of sta...
Financing universal coverage in Kenya A case study
Introduction: One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different syste...
Atypical Presentation of Aggressive Vertebral Hemangioma with Spinal Cord Compression
Symptomatic aggressive vertebral hemangiomas are rare sub variety of much common benign asymptomatic vertebral hemangioma presenting with bone expansion, extra osseous extension, epidural soft tissue component, compressi...
Diabetic foot infections and management: A Rural Indian Perspective
Aim and objective: This study was carried out to study demographic features and diabetic foot infections and its management. Study design: It is a hospital based observational study. Place and duration of study: Depart...