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Cost of complex abdominal wall reconstruction with biological prostheses in a French public hospital

Abstract : Goal Retrospective analysis of bioprosthetic abdominal wall reconstruction in our center with regard to expenses and reimbursement. Patients and methods This study included all patients undergoing bioprosthetic abdominal wall reconstruction between 2009 and 2015. All costs were considered in determining the hospital expenditures. Next we compared the incoming revenue for each hospital stay based on disease-related groups (DRG) and additional daily hospital fees. Results Seventy-six patients underwent abdominal wall reconstruction, 67 of whom had economical data that were exploitable. On the average, our center lost € 15,233 for every hospital stay associated with bioprosthetic abdominal wall reconstruction. The existing DRG system is not well adapted to provide adequate reimbursement for costs related to complex abdominal wall repairs, especially when post-operative morbidity leads to prolonged hospital stay and increased expenses. Conclusion Abdominal wall repairs with bioprostheses are expensive and are poorly reimbursed in the French Health care system, mainly because they are often associated with complications that increase the costs considerably. In our opinion, it seems necessary that either reimbursement of this type of prosthesis should be higher than the current DRG allows, or that the DRG classification be redefined, or even, that a specific DRG be created for complex abdominal wall reconstruction.
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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01935836
Contributeur : Lnc - Université de Bourgogne <>
Soumis le : mardi 27 novembre 2018 - 10:05:47
Dernière modification le : mercredi 28 novembre 2018 - 01:02:54

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C. Law-Ki, C. Robineau, N. Garnier, M.-P. Guenfoudi, A. Lazzarotti, et al.. Cost of complex abdominal wall reconstruction with biological prostheses in a French public hospital. Journal of Visceral Surgery, Elsevier, 2018, 155 (5), pp.349 - 353. ⟨10.1016/j.jviscsurg.2018.08.001⟩. ⟨hal-01935836⟩

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