title: Cost of radiofrequency ablation in the treatment of hepatic malignancies.
abstract: OBJECTIVE
  Our primary objective was to assess the cost of radio-frequency ablation (RFA) of hepatic malignancies and to compare it to hospital reimbursement paid in the French Prospective Payment System (PPS).
  
  
  METHODS
  A series of 305 patients were enrolled into a prospective study. All resources used during the RFA-related hospital stay were recorded. Costs were assessed from the perspective of the health care providers and computed for four groups of patients: percutaneous RFA in an outpatient setting (group Ia, N=44), percutaneous RFA in an inpatient setting (group Ib, N=94), laparoscopic RFA (group II, N=44) and intraoperative RFA combined with resection (group III, N=120).
  
  
  RESULTS
  Mean hospital costs were estimated at euro 1581 (group Ia), euro 3824 (group Ib), euro 8194 (group II) and euro 12967 (group III). Costs per stay without intensive care in these groups were respectively euro 1581, euro 3635, euro 6622 and euro 10905 and reimbursement (intensive care excluded) was euro 560, euro 3367, euro 9084 and euro 11780.
  
  
  CONCLUSIONS
  In the French PPS, the cost of RFA is covered by lump sums paid to hospitals exclusively for intraoperative and laparoscopic RFA. For percutaneous RFA, which is the most frequent approach, reimbursement is highly insufficient.
authors.affiliation: Department of Health Economics, Gustave Roussy Institute, 39 rue Camille-Desmoulins, Villejuif Cedex. bonastre@igr.fr
authors.forename: Julia
authors.initials: J
authors.lastname: Bonastre
authors.forename: Thierry
authors.initials: T
authors.lastname: De Baère
authors.forename: Dominique
authors.initials: D
authors.lastname: Elias
authors.forename: Serge
authors.initials: S
authors.lastname: Evrard
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouanet
authors.forename: Christophe
authors.initials: C
authors.lastname: Bazin
authors.forename: Marc
authors.initials: M
authors.lastname: Giovannini
authors.forename: Jean Robert
authors.initials: JR
authors.lastname: Delpero
authors.forename: Gérard
authors.initials: G
authors.lastname: De Pouvourville
authors.forename: Frédéric
authors.initials: F
authors.lastname: Marchal
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000191:economics / Q000601:surgery; D017115:Catheter Ablation / Q000191:economics*; D005260:Female; D005602:France; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008113:Liver Neoplasms / Q000191:economics* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012051:Reimbursement Mechanisms