title: Comparison of costs of endovascular repair versus open surgical repair for abdominal aortic aneurysm in Korea.
abstract: This study was designed to compare the hospital-related costs of elective abdominal aortic aneurysm (AAA) treatment and cost structure between endovascular aneurysm repair (EVAR) and open surgical repair (OSR) in Korean health care system. One hundred five primary elective AAA repairs (79 OSRs and 26 EVARs) performed in the Seoul National University Hospital from 2005 to 2009 were included. Patient characteristics were similar between two groups except for older age (P = 0.004) and more frequent history of malignancy (P = 0.031) in EVAR group. Thirty-day mortality rate was similar between two groups and there was no AAA-related mortality in both groups for 5 yr after repair. The total in-hospital costs for the index admission were significantly higher in EVAR patients (mean, KRW19,857,119) than OSR patients (mean KRW12,395,507) (P < 0.001). The reimbursement was also significantly higher in EVAR patients than OSR patients (mean, KRW14,071,081 vs KRW6,238,895, P < 0.001) while patients payments was comparable between two groups. EVAR patients showed higher follow-up cost up to 2 yr due to more frequent imaging studies and reinterventions for type II endoleaks (15.4%). In the perspective of cost-effectiveness, this study suggests that the determination of which method to be used in AAA treatment be more finely trimmed and be individualized.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Min
authors.forename: Seung-Kee
authors.initials: SK
authors.lastname: Min
authors.forename: Sanghyun
authors.initials: S
authors.lastname: Ahn
authors.forename: Suh Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Daedo
authors.initials: D
authors.lastname: Park
authors.forename: Taejin
authors.initials: T
authors.lastname: Park
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
authors.forename: Jongwon
authors.initials: J
authors.lastname: Ha
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
authors.forename: In Mok
authors.initials: IM
authors.lastname: Jung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000191:economics / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000191:economics*; D003362:Cost-Benefit Analysis; D057867:Endoleak; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007349:Insurance, Health, Reimbursement; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D016019:Survival Analysis; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000191:economics*