REGULAR CONTENT
Final ID
484
Type
Original Scientific Research-Oral or Pos
Authors
A El-Ali1, R Bandi2
Institutions
1University of Pittsburgh Medical Center, Pittsburgh, PA, 2University of Pittsburgh Medical Center, Pittsburgh, PA, Pittsburgh, PA
Purpose
Combination of transarterial chemoembolization (TACE) with microwave ablation (MWA) may provide improved local control and overall survival rates without significant increase in complication rates (1–3). Current protocols for combination TACE-MWA vary widely in many regards including treatment timing (same day vs different days). Herein we describe a cost analysis of same day TACE-MWA vs different day TACE-MWA.
Materials & Methods
Standard protocol for TACE-MWA on different days involves admission, TACE, overnight hospitalization and then discharge. The patient will then be brought back at a later date for a same day MWA procedure and discharge home. Standard protocol for TACE-MWA on same day involves admission, TACE, recovery, MWA, overnight hospitalization and then discharge. Workflow analysis included time analysis of patients from admission to discharge and whichever in-hospital transfers occurred. This was performed on 3 representative patients from same day and different day TACE-MWA groups. Operating costs (in USD) were procured from our VA hospital's managerial cost accounting system. Costs were assessed for several representative patients undergoing TACE (n=2), MWA (n=2), TACE-MWA (same day) (n=3), and TACE-MWA (different day) (n=4). Prior work was referenced for certain aspects of the work hour calculations (4).
Results
Workflow analysis revealed that same day procedures required an average 2.2 hours less for intake/discharge per combined TACE-MWA. This resulted in differences in avg hospitalization time (30 h vs 19.8 h). Additionally, instead of spending their entire post-TACE course in an inpatient observation bed, same day procedure patients were receiving therapy thereby decreasing time spent in an observation bed by 4.1 hours. After controlling for procedure specific costs patients who underwent different day procedures had 18% higher average operating costs for their stays ($11,877 vs $10,057). Costs for single therapy groups (TACE or Ablation) were essentially identical.
Conclusions
In our small series, patients receiving TACE-MWA on separate days spent more time in the hospital (10.2 hours) and had higher costs ($11,877 vs $10,057) associated with their visits.
Final ID
484
Type
Original Scientific Research-Oral or Pos
Authors
A El-Ali1, R Bandi2
Institutions
1University of Pittsburgh Medical Center, Pittsburgh, PA, 2University of Pittsburgh Medical Center, Pittsburgh, PA, Pittsburgh, PA
Purpose
Combination of transarterial chemoembolization (TACE) with microwave ablation (MWA) may provide improved local control and overall survival rates without significant increase in complication rates (1–3). Current protocols for combination TACE-MWA vary widely in many regards including treatment timing (same day vs different days). Herein we describe a cost analysis of same day TACE-MWA vs different day TACE-MWA.
Materials & Methods
Standard protocol for TACE-MWA on different days involves admission, TACE, overnight hospitalization and then discharge. The patient will then be brought back at a later date for a same day MWA procedure and discharge home. Standard protocol for TACE-MWA on same day involves admission, TACE, recovery, MWA, overnight hospitalization and then discharge. Workflow analysis included time analysis of patients from admission to discharge and whichever in-hospital transfers occurred. This was performed on 3 representative patients from same day and different day TACE-MWA groups. Operating costs (in USD) were procured from our VA hospital's managerial cost accounting system. Costs were assessed for several representative patients undergoing TACE (n=2), MWA (n=2), TACE-MWA (same day) (n=3), and TACE-MWA (different day) (n=4). Prior work was referenced for certain aspects of the work hour calculations (4).
Results
Workflow analysis revealed that same day procedures required an average 2.2 hours less for intake/discharge per combined TACE-MWA. This resulted in differences in avg hospitalization time (30 h vs 19.8 h). Additionally, instead of spending their entire post-TACE course in an inpatient observation bed, same day procedure patients were receiving therapy thereby decreasing time spent in an observation bed by 4.1 hours. After controlling for procedure specific costs patients who underwent different day procedures had 18% higher average operating costs for their stays ($11,877 vs $10,057). Costs for single therapy groups (TACE or Ablation) were essentially identical.
Conclusions
In our small series, patients receiving TACE-MWA on separate days spent more time in the hospital (10.2 hours) and had higher costs ($11,877 vs $10,057) associated with their visits.