[Embolization of intracranial aneurysms: reimbursement and perspectives].
OBJECTIVE
To determine the costs related to the embolization of intracranial aneurysms compared to "rates per activity" (T2A) reimbursements.


METHODS
The hospital admissions of patients with intracranial aneurysms treated with embolization and classified under diagnosis-related group (DRG) 01K02Z in 2007 were included. The costs related to the single-use devices, neurointerventional suite and hospital stay were calculated by analytical accounting. Revenues were calculated based on DRG-based medical information system (PMSI) and medical data using the diagnosis-related groups and reimbursements from 2007 (V10 of DRG) and 2009 (V11).


RESULTS
Fifty-seven patients were included. The total cost was 932.278 euro and hospital revenues were 655.648 euro in 2007 and would have been 825.211 euro in 2009. The financial loss was on average 4.853 euro per admission in 2007 and 1.878 euro in 2009, and even more in two cases of ruptured aneurysm.


CONCLUSIONS
In 2001, embolization of intracranial aneurysms, the treatment of choice for this pathology, results in a financial loss for the hospital, larger for ruptured aneurysms compared to non-ruptured aneurysms. The updated DRG, while improving the situation, remains insufficient.
Labalette
C
C
Service de santé publique et économie de la santé, Groupe hospitalier Lariboisière-Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France. celine.labalette@lrb.aphp.fr
Houdart
E
E
David
S
S
Rymer
R
R
Duteil
C
C
Tacnet
J F
JF
Soyer
P
P
Segouin
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D039702:Current Procedural Terminology; D003953:Diagnosis-Related Groups / Q000191:economics; D004621:Embolization, Therapeutic / Q000191:economics*; D005260:Female; D005602:France; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D002532:Intracranial Aneurysm / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics*; D012189:Retrospective Studies; D055815:Young Adult