Μέθοδος της διαδερμικής θερμοκαυτηρίασης RFA για την αντιμετώπιση του καρκίνου του ήπατος : ανάλυση κόστους και δεδομένων ποιότητας ζωής
Method of perrcutaneous radiofrequency ablation for the treatment of liver malignity : cost analysis and data quality of life
Considering the enterprising model, a lot of economists try to analyze the economic Behavior of hospitals, beyond their social character. The discussions are focused in the configuration of certain tools of effectiveness and productivity of hospital units, aiming these to be better determined, as the cost of health services increases diachronically. Taking under consideration that Liver cancer represents the sixth most common cancer worldwide. In Europe, about 10 in every 1,000 men and 2 in every 1,000 women will develop liver cancer at some point in their life Worldwide it is much more frequent in South-East Asia and Western Africa. This is mainly due to the fact that infection with the hepatitis B virus increases the risk of developing liver cancer and is more frequent in these areas. In the USA and in Southern Europe, the Hepatitis C virus is seen more frequently as a cause of liver cancer. In 2008, about 40,000 men and about 20,000 women were diagnosed with liver cancer in Europe. The median age at diagnosis is between 50 and 60 years, but in Asia and Africa it is usually between 40 and 50 years. Percutaneous radiofrequency ablation is a relative new, minimally invasive technique that is considered the best treatment option for patient with liver malignity. The improvement of equipment and the increased expertise of interventional radiologists have greatly contributed to a high level of treatment efficacy and a low incidence of complications of image-guided RFA. Reduced mortality, morbidity and hospitalization are considered major advantages rendering RFA as a promising alternative, not only in controlling malignant disease, but also in improving survival rate for patients with limited but unresectable disease. Our primary objective was to assess the cost of Comptuted Tomography (CT)-guided radiofrequency Ablation (RFA), to evaluate the efficacy and complications of hepatic malignancies and at least to evaluate by Numerical Rating Scale – NRS method the quality of life of the patients. The method was a retrospective study of 149 patients (92 men and 57 women) the average of age was 67 years, with 203 lesions of hepatic malignancies who had been treated by (CT)-guided radiofrequency Ablation (RFA) at Years 2013-2014.The tumors were considered as ablated completely. If no viability was found on dual-phase dynamic contrast enhanced CT at 1 month after RFA. All resources used during the RFA-related hospital stay were recorded. Costs were assessed from the retrospective of the health care providers. The mean Annual cost was evaluated and mean cost per patient, too. The results of this study support that RFA is an effective and safe technique for the treatment of hepatic malignancies. Taking into accounts of results of the current study, the classification into the system of K.E.N. it is considered necessary. The mean cost per patient does not differ posotically with that of other international papers but in Greece applied differ costing. It is essential to develop a system of Resource-Based Relative Value Scale(RBRVS) as a financial assessment tool as a proposition for a real costing of this particular method, which will be common for all public healthcare providers in Greece.