[Correlation between the real cost of an intervention and cost factors in France: example of removal of jaw fixation material in mandibular fractures].
BACKGROUND
economic cost is a timely topic which will have to be taken in consideration more and more for determining the appropriate indication for surgical procedures. "Health has no price, but it has a cost" is a common proverb urging us to think in terms real cost of a surgical procedure. The purpose of this study is to estimate the real cost of a usual and frequent intervention: removal of osteosynthesis material in mandibular fractures. Real cost was compared with the cost charged by the French health insurance fund.


METHODS
this retrospective study collected all the interventions concerning material removal after mandibular fractures performed in our department during 2002. The following parameters were retained: the number of consultations, the duration of occupation of the surgical unit and the recovery room, the list of materials and products used, the cost of the medical staffs and cleaning agents, the duration of hospitalization, other administrative loads and expenses.


RESULTS
a series of 30 patients was found, each patient had had three consultations, the average duration of hospitalization was 36 hours, the time of occupation of the surgical unit was 100 minutes and occupation of the recovery room was 2 hours. The total real cost of this intervention was 510 Euros, the cost estimated by the health insurance fund was 110 Euros and the cost of hospitalisation charged was 997 Euros.


CONCLUSIONS
these results show us the real cost of this intervention and the cost estimated by the French health insurance fund. It is highly noteworthy that the cost estimates were totally inadequate. This study leads to a discussion concerning a more global approach to the cost-benefit ratio of such an intervention as well as the indication for bioabsorbable material compared with titanium in facial traumatology.
El Khatib
K
K
Service de Chirurgie Maxillo-faciale et Chirurgie Plastique, Hôpital Général, CHU de Dijon, 3, rue du Faubourg Raines 21033, Dijon.
Danino
A
A
Malka
G
G
D003362:Cost-Benefit Analysis; D005593:Fracture Fixation, Internal / Q000191:economics*; D005602:France; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D016268:Internal Fixators / Q000191:economics; D019248:Jaw Fixation Techniques / Q000191:economics*; D008337:Mandibular Fractures / Q000191:economics* / Q000601:surgery; D012189:Retrospective Studies