Document Detail


Cost analysis of intraoperative neurophysiological monitoring (IOM)
MedLine Citation:
PMID:  12518256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: A number of studies demonstrate that a significant reduction of postoperative neurological deficits can be achieved by applying intraoperative neurophysiological monitoring (IOM) methods. A cost analysis of IOM is imperative considering the strained financial situation in the public health services. MATERIAL AND METHODS: The calculation model presented here comprises two cost components: material and personnel. The material costs comprise consumer goods and depreciation of capital goods. The computation base was 200 IOM cases per year. Consumer goods were calculated for each IOM procedure respectively. The following constellation served as a basis for calculating personnel costs: (a) a medical technician (salary level BAT Vc) for one hour per case; (b) a resident (BAT IIa) for the entire duration of the measurement, and (c) a senior resident (BAT Ia) only for supervision. RESULTS: An IOM device consisting of an 8-channel preamplifier, an electrical and acoustic stimulator and special software costs 66,467 euros on the average. With an annual depreciation of 20%, the costs are 13,293 euros per year. This amounts to 66.46 euros per case for the capital goods. For reusable materials a sum of 0.75 euro; per case was calculated. Disposable materials were calculate for each procedure respectively. Total costs of 228.02 euro; per case were,s a sum of 0.75 euros per case was calculated. Disposable materials were calculate for each procedure respectively. Total costs of 228.02 euros per case were, calculated for surgery on the peripheral nervous system. They amount to 196.40 euros per case for spinal interventions and to 347.63 euros per case for more complex spinal operations. Operations in the cerebellopontine angle and brain stem cost 376.63 euros and 397.33 euros per case respectively. IOM costs amount to 328.03 euros per case for surgical management of an intracranial aneurysm and to 537.15 euros per case for functional interventions. Expenses run up to 833.63 euros per case for operations near the motor cortex and to 117.65 euros per case for intraoperative speech monitoring. DISCUSSION: Costs for inpatient medical rehabilitation have increased considerably in recent years. In view of the financial situation, it is necessary to reduce postoperative morbidity and the costs it involves. IOM leads to a reduction of morbidity. The costs for IOM calculated here justify its routine application in view of the legal and socioeconomic consequences of surgery-related neurological deficits.
Authors:
T Kombos; O Suess; M Brock
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Zentralblatt für Neurochirurgie     Volume:  63     ISSN:  0044-4251     ISO Abbreviation:  Zentralbl. Neurochir.     Publication Date:  2002  
Date Detail:
Created Date:  2003-01-08     Completed Date:  2003-03-25     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0413646     Medline TA:  Zentralbl Neurochir     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  141-5     Citation Subset:  IM    
Affiliation:
Neurochirurgische Klinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin. kombos@medizin.fu-berlin.de
Vernacular Title:
Kostenanalyze des intraoperativen neurophysiologischen Monitorings (IOM).
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Cost-Benefit Analysis
Costs and Cost Analysis
Electroencephalography
Electromyography
European Union
Humans
Internship and Residency / economics
Models, Economic
Monitoring, Intraoperative / economics*,  instrumentation
Nervous System Diseases / economics,  prevention & control
Nervous System Physiological Phenomena*
Operating Room Technicians / economics
Polysomnography

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