Cost of Treatment of Cerebral Aneurysm Embolization: Study of Associated Factors.
BACKGROUND
Surgical clipping or endovascular coiling are the main procedures used in the treatment of cerebral aneurysms, with a preference for endovascular coiling. In Morocco, the number of patients needing endovascular coiling is growing, but many of them do not have access to this technique. The aim of this study was to determine the main parameters associated with variations in the total cost of this procedure in order to establish the amount (lump sum) that may be reimbursed by health insurance funds.


METHODS
One hundred and seventeen patients with 124 aneurysms were admitted for treatment of one or more intracranial aneurysms between January 2010 and December 2015. The overall cost of hospitalization was assessed by using the micro-costing technique. The calculation was based on the tariffs of medical procedures as defined by the Ministry of Health in Morocco. A regression analysis was used to define the correlation between the overall cost and the various parameters.


RESULTS
Univariate linear regression showed that the total cost was influenced by overall duration of hospitalization, ICU duration of hospitalization and size of aneurysm. On the other hand, univariate linear regression showed that the total cost was not influenced by sex, localization of aneurysm, and size of the aneurysm's neck. However, multivariate linear regression showed that the total cost was influenced by one type of insurance health, overall duration of hospitalization, ICU duration of hospitalization, size of the aneurysm, and size of the aneurysm's neck.


CONCLUSIONS
Setting a rate for reimbursement of patients who have had coiling treatment for a cerebral aneurysm should take into account the results of our study in order to limit the costs borne by patients. The parameters that influence the overall cost must be reimbursed in each case while the parameters that do not influence treatment costs could be included in a lump sum.
Faculty of Medicine, Abulcasis University, Rabat, Morocco. Cheikh.amine@gmail.com.|Team of Pharmacoepidemiology and Pharmacoeconomics, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco. Cheikh.amine@gmail.com.|Department of Pharmacy, Cheikh Zaid Hospital, Rabat, Morocco. Cheikh.amine@gmail.com.
Amine
A
Cheikh
Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Razine
R
Rachid
Neurogenetics Research Team, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Aasfara
A
Jehanne
Department of Intensive Care, Cheikh Zaid Hospital, Rabat, Morocco.
Ababou
A
Adil
Faculty of Medicine, Abulcasis University, Rabat, Morocco.|Neurogenetics Research Team, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Benomar
B
Ali
Team of Pharmacoepidemiology and Pharmacoeconomics, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Yahya
Y
Cherrah
Department of Pediatrics, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.|Cheikh Zaid Hospital, Rabat, Morocco.
El Hassani
EH
Amine
Department of Neuroradiology, Cheikh Zaid Hospital, Rabat, Morocco.
El Quessar
EQ
Abdeljalil
Aneurysm embolization; Endovascular coil; Health insurance; Micro-costing; Reimbursement