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Kosten der Behandlung der intrakraniellen Aneurysmata und aneurysmatischen Subarachnoidalblutung in Österreich
Kateryna Gryn
Art der Arbeit
Masterarbeit
Universität
Universität Wien
Fakultät
Fakultät für Wirtschaftswissenschaften
Studiumsbezeichnung bzw. Universitätlehrgang (ULG)
Masterstudium Internationale Betriebswirtschaft
Betreuer*in
Michaela-Maria Schaffhauser-Linzatti
DOI
10.25365/thesis.55230
URN
urn:nbn:at:at-ubw:1-21479.48020.886771-6
Link zu u:search
(Print-Exemplar eventuell in Bibliothek verfügbar)
Abstracts
Abstract
(Deutsch)
Subarachnoidalblutung stellt eine Sonderform eines Schlaganfalls dar und wird in den meisten Fällen durch rupturierte intrakranielle Aneurysmen (Aussackungen der Hirnarterien) versuracht. Da die Mortalitätsrate bei einer Subarachnoidalblutung im Vergleich zu den anderen Formen des Schlaganfalls relativ hoch ist und bei den Überlebenden häufig mit schweren gesundheitlichen Beeinträchtigungen sowie Arbeitsunfähigkeit zu rechnen ist, stellt die SAB ein aktuelles gesundheitliches Problem aus medizinischer, demographischer und ökonomischer Sicht dar. Ein rupturiertes Aneurysma muss neurochirurgisch mithilfe von Klippung oder neuroradiologisch durch Coiling versorgt werden. In dieser Arbeit werden die Kosten dieser zwei Behandlungsverfahren mit Berücksichtigung der Diagnostik, Liegedauern, Wiederbehandlungs- sowie Mortalitätsraten geschätzt und miteinander verglichen.
Abstract
(Englisch)
Introduction: Ruptured intracranial aneurysms cause subarachnoid hemorrhage, a condition which poses a significant health hazard due to its high rates of mortality and disability. Over the last decades there has been an ongoing debate about the two most commonly used treatment modalities of intracranial aneurysms, namely neurosurgical clipping and endovascular coiling. Through the decision about whether clipping or coiling should be performed in every case is made based on the medical indication, nevertheless, due to the high socioeconomic burden of subarachnoid hemorrhage, it is also important to compare the healthcare expenditures, caused by clipping and coiling.
Methods: In this study we estimated and compared treatment costs of clipping, coiling and stent-assisted coiling (SAC) of both ruptured (RIA) and unruptured (UIA) aneurysms in Austria. Important cost factors were surgery costs, costs of the diagnostic imaging, costs of post-operative in-hospital care, cost of treatment of the complications and costs of initial rehabilitation treatment. Cost-related data was provided by the Vienna General Hospital. Epidemiological data and the duration of stay, complications and mortality rates were obtained from previous studies. Based on this information, a decision tree was built.
Results: Coiling was significantly more expensive compared to clipping when only the surgery costs were considered (13.303,98 Euro for Coiling and 24847.63 Euro for SAC vs. 6.835,23 Euro for Clipping). The main cost-driving factor were the costs of implants. However, clipping caused higher costs of in-hospital stay and initial rehabilitation. Altogether, when considering all in-hospital costs, mortality rates, and the cost of rehabilitation treatment, the difference in costs of aneurysm clipping and coiling was much less pronounced.
Discussion: To our knowledge, this study is the first attempt to estimate the treatment costs of RIA and UIA in Austria. The costs of the most common treatment complications were also included in our analysis. However, the economic comparison in this study is partially based on estimations and does include opportunity and long-term costs.
Schlagwörter
Schlagwörter
(Englisch)
Aneurysm clipping coiling stent-assisted coiling SAC RIA UIA SAH subarachnoid hemorrhage stroke surgery costs healthcare costs neurosurgery vascular neurosurgery neurosurgery costs neurosurgery costs cost comparison intracranial aneurysm decision tree
Schlagwörter
(Deutsch)
Aneurysma Klippung Coiling stent-assisted coiling SAC RIA UIA SAB Subarachnoidalblutung Schlaganfall Neurochirurgie OP-Kosten Entscheidungsbaum Kostenvergleich
Autor*innen
Kateryna Gryn
Haupttitel (Deutsch)
Kosten der Behandlung der intrakraniellen Aneurysmata und aneurysmatischen Subarachnoidalblutung in Österreich
Paralleltitel (Englisch)
Economic comparison between endovascular coiling versus neurosurgical clipping for ruptured and unruptured intracranial aneurysms in Austria
Publikationsjahr
2018
Umfangsangabe
xii, 111 Seiten : Illustrationen, Diagramme
Sprache
Deutsch
Beurteiler*in
Michaela-Maria Schaffhauser-Linzatti
Klassifikation
85 Betriebswirtschaft > 85.99 Betriebswirtschaft: Sonstiges
AC Nummer
AC15244593
Utheses ID
48809
Studienkennzahl
UA | 066 | 914 | |