Inpatient Costs And Cost-effectiveness Analysis On Two Kinds Of Surgical Treatment Of The Basal Ganglia Hypertension Intracerebral Hemorrhage

Objective Hospitalization costs analysis of basal ganglia hemorrhage provide a positive reference information for the health care decisions; Cost-effectiveness analysis for puncture drainage hose (hereinafter referred to as minimally invasive group) and accumulated experience surgical hematoma evacuation (hereinafter referred to as craniotomy group) were studied for the more in-depth follow-up evaluation of basal ganglia intracerebral hemorrhage.Methods (1) Patients from neurosurgery ward basal ganglia hemorrhage patients were surgically treated between1January2012to31June2013were collected;(2) Information of the patients were analyzed by SPSS19.0statistical software and carried out cost-effectiveness analysis.Results:(1) The study included152cases of patients, male to female ratio was2.45:1. Sex differences in the two groups were not statistically significant (P>0.05); Average age of minimally invasive group was54.52years, craniotomy group was56.23years, the difference was not statistically significant (P=0.071); During minimally invasive group admission and craniotomy, the difference in GCS was not statistically significant (P=0.415); The average amount bleeding of minimally invasive group and craniotomy group respectively41.23ml and43.53ml, the difference was not statistically significant (P=0.096); Differences in the minimally invasive group and craniotomy group of hypertension, diabetes, history of taking aspirin, history of heart disease and stroke were not statistically significant aspects (P＞0.05); the average number of days of hospitalization of minimally invasive group and craniotomy group was17.34days and18.17days, no statistically significant difference (P=0.071).(2) The incidence of Postoperative infections in minimally invasive group was23.90%and rebleeding was11.96%; craniotomy group were45.00%and8.33%respectively. Differences between the two groups in the incidence of postoperative infection was statistically significant (P<0.005), incidence of rebleeding difference was not statistically significant (P>0.05); One month mortality of Minimally invasive group and craniotomy group were6.52%and18.33%, there were statistically significant (P<0.05); Minimally invasive group and craniotomy group after6months of life basic self-care rates were71.73%and61.67%respectively, the difference was statistically significant (P＜0.001).(3) The average hospitalization cost of patients were53,618.43RMB, the average daily cost of hospitalization was3779.60RMB. The average daily cost and average daily cost of two groups were statistically significant (Z=-7.376, P＜0.001; Z=-7.826, P＜0.001); Differences of costs of two groups were statistically significant in the drugs (P＜0.001), the cost of treatment (p=0.013), inspection fee (p<0.001), laboratory tests (P=0.001), surgery (P＜0.001), materials (P<0.001).(4)The result of cost-effectiveness analysis displyed, the cost of minimally invasive group were lower than craniotomy group in each save one patient, one case each get their basic self-care patients to avoid one case per patient postoperative bleeding,and so on. The result of incremental cost-effectiveness analysis displyed, the minimally invasive group saved more than1patient each takes1630.86RMB, more than to get one case per basic self-care patients living takes2011.39RMB, a decrease of1per postoperative bleeding patients need to spend2320.84RMB, a decrease of1per postoperative infection takes1946.51RMB, relative to the craniotomy. Minimally invasive treatment group had better economic results.Conclusions (1) In the surgical treatment of30-60ml of the basal ganglia hemorrhage, puncture drainage had better economic results.(2) postoperative bleeding of puncture drainage was higher, so we need to strengthen the monitor of patient’s life symptoms.(3)Puncture drainage in patients was significantly lower than the cost of hospitalization in patients with hematoma evacuation; Comparing the costs of two costs, mainly different aspects were medicine, treatment fees, inspection fees, laboratory fees, surgery fees, materials fees.