高流量、高コスト?時間駆動型活動基準コスト計算を用いたもやもや病の直接バイパス vs 間接バイパスのパイロット比較研究
Advith Sarikonda1, Danyal Quraishi2, Arbaz Momin2
1Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.
まとめ
成人もやもや病(MMD)に対する直接バイパス(DB)手術は、主に消耗品コストの増加により、間接バイパス(IB)手術よりも高価である。この結果は、MMD治療における手術の選択や資源配分に情報を提供する可能性がある。
科学分野:
- 脳神経外科
- ヘルスエコノミクス
背景:
- もやもや病(MMD)の管理には、コストへの影響が不明確な直接バイパス(DB)と間接バイパス(IB)が含まれる。
- コストは、成人MMDの手術選択に影響を与える重要な要因である。
主な方法:
- 再建術を受けた38人の成人MMD患者(2017-2022年)の後ろ向きコホート研究。
- 時間駆動型活動基準コスト計算(TDABC)により、術中の消耗品および人件費を算出した。
- 患者要因を調整したDBとIBのコスト差を多変量回帰分析で解析した。
結論:
- 成人もやもや病(MMD)に対する直接バイパス(DB)手術は、消耗品支出の増加により、間接バイパス(IB)よりも高価である。
- TDABC手法は、MMD再建術のコストドライバーに関する詳細な洞察を提供する。
- この結果は、MMD治療のための手術意思決定、機関の予算編成、およびリソースの最適化を導くことができる。
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