title: Cost comparison between surgical treatments and endoscopic submucosal dissection in patients with early gastric cancer in Korea.
abstract: OBJECTIVE
  This study was conducted to evaluate whether medical costs can be reduced using endoscopic submucosal dissection (ESD) instead of conventional surger-ies in patients with early gastric cancer (EGC).
  
  
  METHODS
  Pa-tients who underwent open gastrectomy (OG), laparoscopy-assisted gastrectomy (LAG), and ESD for EGC were recruited from three medical institutions in 2009. For macro-costing, the medical costs for each patient were derived from the ex-penses incurred during the patient's hospital stay and 1-year follow-up. The overall costs in micro-costing were determined by multiplying the unit cost with the resources used during the patients' hospitalization.
  
  
  RESULTS
  A total of 194 patients were included in this study. The hospital stay for ESD was 5 to 8 days and was significantly shorter than the 12-day hospital stay for OG or the 11- to 17-day stay for LAG. Using macro-costing, the average medical costs for ESD during the hospital stay ranged from 2.1 to 3.4 million Korean Won (KRW) per patient, and the medical costs for conventional surgeries were estimated to be between 5.1 million and 8.2 million KRW. There were no significant differences in the 1-year follow-up costs between ESD and conventional surger-ies.
  
  
  CONCLUSIONS
  ESD patients had lower medical costs than those patients who had conventional surgeries for EGC with conservative indications. (Gut Liver, 2015;9174-180).
authors.affiliation: National Evidence-Based Healthcare Collaborating Agency, Seoul and Institute of Health and Environment, Seoul National University, Seoul, Korea.
authors.forename: Younhee
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Center for Gastric Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Young Woo
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Center for Gastric Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
authors.affiliation: National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Institute of Health and Environment, Seoul National University, Seoul and College of Pharmacy, Kyungpook National University, Daegu, Korea.
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kwon
authors.affiliation: Institute of Health and Environment, Seoul National University, Seoul, Korea.
authors.forename: Ja Youn
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Institute of Health and Environment, Seoul National University, Seoul, Korea.
authors.forename: Na Rae
authors.initials: NR
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Seol
mesh_terms: D003365:Costs and Cost Analysis; D004210:Dissection / Q000191:economics* / Q000379:methods; D005743:Gastrectomy / Q000191:economics* / Q000379:methods; D005753:Gastric Mucosa / Q000601:surgery; D005773:Gastroscopy / Q000191:economics* / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D056910:Republic of Korea; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Costs and cost analysis; Endoscopic submucosal dissection; Gastrectomy; Stomach neoplasms