Ann Surg Treat Res.  2015 Oct;89(4):202-207. 10.4174/astr.2015.89.4.202.

Cost comparison between endoscopic submucosal dissection and transanal endoscopic microsurgery for the treatment of rectal tumors

• Nam MJ
• Sohn DK
• Hong CW
• Han KS
• Kim BC
• Chang HJ
• Park SC
• Oh JH

• KMID: 2166891
• DOI: http://doi.org/10.4174/astr.2015.89.4.202

Abstract

PURPOSE
To compare medical costs of endoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) for the treatment of rectal tumors.
METHODS
The records of 80 patients who underwent ESD and 32 who underwent TEM for the treatment of rectal tumors were collected. Factors compared in the two groups included patient age, sex and clinical characteristics, as well as hospital stay, procedure time, instrument use, medications, postoperative complications, and imaging and laboratory findings. Costs were analyzed based on medical insurance fees, as set publicly by the Ministry of Health & Welfare, Korea. Medical costs were also divided into patient copayments and National Health Insurance (NHI) Corporation charges.
RESULTS
Patient characteristics, including age, sex, and comorbidities, were similar in the two groups, as were procedure time, histologic diagnosis, tumor size and distance from the anal verge, hospital stay, and complication rates. Median total hospital costs were significantly lower in the ESD than in the TEM group (1,214 United State dollars [USD] vs. 1,686 USD, P < 0.001). The costs for consumables, drugs and laboratory as well as operation fee were also significantly lower in the ESD than in the TEM group. However, patient copayments in the ESD group were significantly higher than in the TEM group (928 USD vs. 496 USD, P < 0.001), because ESD procedure for rectal tumors is not yet covered by the Korean NHI.
CONCLUSION
Overall direct medical costs were significantly lower for ESD than for TEM in the treatment of rectal tumors.

Keyword

Endoscopic surgical procedure; Transanal endoscopic microsurgery; Rectal neoplasms; Local excision; Costs and cost analysis

MeSH Terms

Comorbidity
Costs and Cost Analysis
Diagnosis
Endoscopy
Fees and Charges
Hospital Costs
Humans
Insurance
Korea
Length of Stay
Microsurgery*
National Health Programs
Postoperative Complications
Rectal Neoplasms*

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