Cost-effectiveness Analysis and Case-based Payment Norm Modeling on Appendicitis Patients at Hanoi Medical University Hospital

NCT ID: NCT03504878

Last Updated: 2018-04-20

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 322 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2011-01-01
• Study Completion Date: 2016-12-31

Brief Summary

In the world, there are several studies comparing the cost-effectiveness between laparoscopic appendectomy and open appendectomy. But in Vietnam, health economics studies for acute appendicitis surgery in general and laparoscopic appendectomy in particular has hardly been available, and in the context of reform of the financial mechanism for payment, questions about the cost-effectiveness between the two surgical methods are particularly concerned. Therefore, we conducted a study "Cost-effectiveness analysis and case-based payment norm modeling in patients with appendectomy at Hanoi Medical University Hospital"

Detailed Description

Acute Appendicitis (AA) is a surgical emergency most common stomach. Appendicitis occurs at all ages. Recently, the rate tends to increase VRTC with age. In the United States, there are about 300,000 cases of appendectomy surgery per year. In Vietnam, according to statistics from a number of other authors showed that the rate of appendectomy surgery accounted for 40.5% - 49.8% of total number of cases of abdominal emergency. Open appendectomy (OA) has long been applied as the gold standard surgical procedure for the treatment of AA for over a century, since it was introduce by McBurrney in 1894 and still be common choice for procedure in many center. In 1981, due to the growth of endoscopic surgery, Semm first introduced the laparoscopic appendectomy, which render a minimal invasive procedure for abdomen and skin, nevertheless, its superiority over open appendectomy (OA) is still being debated. Some more recent paper demonstrate that Laparoscopic Appendectomy is the technique of choice in treatment of AA because of its clinical advantage and cost-effectiveness, however, more than 20 years later, the benefits of LA still remain a controversy for many researchers.

There are several studies comparing the cost-effectiveness between laparoscopic appendectomy and open appendectomy in the world. But in Vietnam, health economics studies for appendix removal surgery in general and laparoscopic appendectomy in particular has hardly been available, and in the context of reform of the financial mechanism for payment, questions about the cost-effectiveness between the two surgical methods are particularly concerned. Therefore, we conducted a study "Cost-effectiveness analysis and case-based payment norm modeling in patients with appendectomy at Hanoi Medical University Hospital" with two main purposes

1. Analyze cost-effectiveness between laparoscopic and open surgery in patients undergoing appendectomy at Hanoi Medical University Hospital in 2011 - 2013

2. Model case-based payment norm of appendectomy patients at Hanoi Medical University Hospital

Conditions

Acute Appendicitis

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Patients undergoing laparoscopic appendectomy

Appendix removal via scope.

Laparoscopic appendectomy

Intervention Type: PROCEDURE

The laparoscopic appendectomy was performed with three trocars. Pneumoperitoneum was created using an open Hasson technique. The mesoappendix was divided using a harmonic scalpel or endoscopic tissue fusion device. The appendix was divided by placing one endoscopic loop and cut with harmonic scalpel. The specimen was removed through the umbilical port.

Patients undergoing open appendectomy

Open operation for removal of appendix

Open appendectomy

Intervention Type: PROCEDURE

The open appendectomy was carried out in the standard way with McBurney muscle splitting incision.

Interventions

Laparoscopic appendectomy

The laparoscopic appendectomy was performed with three trocars. Pneumoperitoneum was created using an open Hasson technique. The mesoappendix was divided using a harmonic scalpel or endoscopic tissue fusion device. The appendix was divided by placing one endoscopic loop and cut with harmonic scalpel. The specimen was removed through the umbilical port.

Intervention Type: PROCEDURE

Open appendectomy

The open appendectomy was carried out in the standard way with McBurney muscle splitting incision.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Laparoscopic Appendectomy patients agree to participate in research and are paid by the mode of service charge
• Laparoscopic Appendectomy patients agree to participate in research and are paid according to package medical cases

Exclusion Criteria

• Patients with combined pathology affecting surgical outcomes
• The patient did not agree to participate in research
• Patients do not comply with treatment

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Hanoi Medical University

OTHER

Sponsor Role: lead

Responsible Party

Bui My Hanh

Director, Science Research and International Cooperation Unit

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Hanoi Medical University

Hanoi, , Vietnam

Countries

Vietnam

Other Identifiers

HMU16224

Identifier Type: -

Identifier Source: org_study_id