Health economic evaluation of surgical treatment of pituitary adenomas in a single center

Bai Jiwei; Li Chuzhong; Zhao Sida; Chen Yiyuan; Cao Lei; Zhang Yazhuo

doi:10.11850/j.issn.1009-122X.2016.02.007

Abstract：Objective To analyze the outcome of surgical treatment of pituitary adenoma in a single center, which may be helpful in improving the treatment efficacy and adjusting health resources. Methods The clinical data of 6750 patients receiving surgery for pituitary adenoma, whose diagnoses were confirmed by pathological examination, were analyzed retrospectively. The age and gender of patients, perioperative mortality, and indicators of health economics related to health care reform (the hospital cost and length of stay) were compared. Results The ratio of male to female patients was 1 to 1.1. The average age was 45.8 ± 12.9 years old and 44.7 ± 12.8 years old in male and female patients respectively when they were treated first time (P<0.05). The number of pituitary tumor surgery increased year by year, which was 1159 cases in 2014. The total mortality rate was 0.22%during the seven years. The median hospital costs was￥21970.5. Hospital costs and length of stay were shortened after the medical reforms were adopted (P<0.05). Hospital costs was at the lowest level in 2014. The costs of transsphenoidal surgeries were less than those of craniotomy surgeries (P<0.05). The costs and hospital length of stay of the patients who died during hospital were more than those of patients who were alive when discharged (P<0.05). Total length and postoperative length of hospital stay were positive correlation with hospital costs respectively. Conclusions The amount of pituitary adenoma surgery is increasing year by year in Tiantan Hospital, while the hospital cost and length of stay is decreasing. Craniotomy costs more medical resources and needs more hospital days compared with transphenoidal surgery. Good therapeutic effect saves medical resources. The medical reforms improve the hospital costs and length of hospital stay.