Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy.
Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the "San Matteo" Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach.
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. World Health Organization Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy.
Roberta
R
Narra
Division of General Surgery, San Matteo Hospital Foundation, Pavia, Italy.
Marcello
M
Maestri
Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas.
Christine M
CM
Budke
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. World Health Organization Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy. f_tamarozzi@yahoo.com.
Francesca
F
Tamarozzi
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. World Health Organization Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy.
Mara
M
Mariconti
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. World Health Organization Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy.
Giovanni J
GJ
Nicoletti
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. World Health Organization Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy.
Francesca
F
Rinaldi
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy. World Health Organization Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy. Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy.
Enrico
E
Brunetti
D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004443:Echinococcosis / Q000191:economics* / Q000469:parasitology / Q000601:surgery*; D048209:Echinococcus granulosus / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000871:Anthelmintics; D015766:Albendazole