Cost analysis of the combined procedure of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).
OBJECTIVE
The aim of the present study was to address the economic cost of the innovative comprehensive approach involving cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal surface malignancies, and to compare it with the financial support received by our centre.


METHODS
A retrospective economic analysis was carried out on 382 consecutive procedures performed at a tertiary referral centre during the period 1995-2008. The costs of the combined therapy were estimated using the activity-based costing methodology. The financial support was assessed according to the current diagnosis-related group classification and reimbursement rates.


RESULTS
The mean cost for one hospital stay was euro36,015.89 (range 28,435.24-82,189.08); mean length of stay was 24.3 days (range 9-108). In counterpart, our hospital received a total financial support of euro804,483.30, resulting in a deficit of euro1861,301.99 for the two years.


CONCLUSIONS
The Italian current diagnosis-related groups classification does not include cytoreduction and HIPEC. This results in a relevant economic deficit for the hospitals offering this treatment option to their patients and a slow diffusion of the technique in our country. Two corrective measures are needed: to include this procedure in the official list of medical acts, and to determine its specific cost for reimbursing.
Baratti
D
D
Department of Surgery, National Cancer Institute, Via Venezian, 1, 20133 Milan, Italy.
Scivales
A
A
Balestra
M R
MR
Ponzi
P
P
Di Stasi
F
F
Kusamura
S
S
Laterza
B
B
Deraco
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000191:economics*; D003131:Combined Modality Therapy / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000191:economics*; D007263:Infusions, Parenteral; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000191:economics*; D055815:Young Adult