کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4278178 1611482 2016 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Cost-conscious decisions in the timing of operation for minimally symptomatic inguinal hernias in male patients
ترجمه فارسی عنوان
تصمیم گیری های هزینه های آگاهانه در زمان عمل برای فتق های مچ دست پریودیکی معکوس در بیماران مردانه
کلمات کلیدی
فتق القایی، باز بدون تنش باز، تعمیر لاپاروسکوپی، مدیریت انتظار، نظارت، ارزش خالص فعلی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی عمل جراحی
چکیده انگلیسی


• Most male patients with asymptomatic inguinal hernia will require repair.
• Mathematical models suggest that early repair is less costly to payers than expectant management.
• Over a ten-year cycle of care, the net present value of money influences overall cost of care.

BackgroundExpectant management (EM) and early open repair (OR) are safe and effective as initial management strategies for minimally symptomatic inguinal hernia in male patients. Extended follow-up of patients in EM protocols have shown that most patients will eventually require repair, but it is not clear which strategy is less costly over the long term.MethodsWe constructed a mathematical model to compare 3rd-party payer expenditures for EM vs OR or laparoscopic repair in a simulated cohort of patients with inguinal hernia. Cohort characteristics and expenditures were calibrated to recent randomized trials that reported initial follow-up and expenditures at 2 years and long-term crossover rates from EM to OR.ResultsCost comparisons between OR and EM are sensitive to direct long-term costs of inpatient and outpatient care, the likelihood of crossover from EM to operation, cost differences between OR and laparoscopic repair, and the net present value of longer-term costs.ConclusionsOur findings suggest that short-term costs of EM are less than those of OR and Lap-R, but early OR provides the highest long-term savings.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The American Journal of Surgery - Volume 211, Issue 6, June 2016, Pages 975–981
نویسندگان
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