Cost comparison between surgical treatments and endoscopic submucosal dissection in patients with early gastric cancer in Korea

• Published in: Gut and liver Vol. 9; no. 2; pp. 174 - 180
• Main Authors: Kim, Younhee, Kim, Young Woo, Choi, Il Ju, Cho, Joo Young, Kim, Jong Hee, Kwon, Jin Won, Lee, Ja Youn, Lee, Na Rae, Seol, Sang Yong
• Format: Journal Article
• Language: English
• Published: Korea (South) Gut and Liver 01-03-2015; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Costs and Cost Analysis; Dissection - economics; Dissection - methods; endoscopic submucosal dissection; gastrectomy; Gastrectomy - economics; Gastrectomy - methods; Gastric Mucosa - surgery; Gastroscopy - economics; Gastroscopy - methods; Humans; Laparoscopy; Length of Stay - statistics & numerical data; Original; Republic of Korea; stomach neoplasms; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; 내과학; Republic of Korea; Endoscopic submucosal dissection; Costs and cost analysis; Gastrectomy; Stomach neoplasms
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl13299

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).
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.
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.
ESD patients had lower medical costs than those patients who had conventional surgeries for EGC with conservative indications. (Gut Liver, 2015;9174-180).