Abstract：
OBJECTIVE: To investigate the assumption that day-case cochlear implantation is associated with lower costs, compared to inpatient cochlear implantation, while maintaining equal quality of life (QoL) and hearing outcomes, for the Dutch healthcare setting.
METHODS: A single-center, non-blinded, randomized controlled trial in a tertiary referral center.
METHODS: Thirty adult patients with post-lingual bilateral sensorineural hearing loss eligible for unilateral cochlear implantation surgery were randomly assigned to either the day-case or inpatient treatment group (i.e., one night admission). We performed an intention-to-treat evaluation of the difference of the total health care-related costs, hospital and out of hospital costs, between day-case and inpatient cochlear implantation, from a hospital and patient perspective over the course of one year. Audiometric outcomes, assessed using CVC scores, and QoL, assessed using the EQ-5D and HUI3 questionnaires, were taken into account.
RESULTS: There were two drop-outs. The total health care-related costs were €41,828 in the inpatient group (n = 14) and €42,710 in the day-case group (n = 14). The mean postoperative hospital stay was 1.2 days (mean costs of €1,069) in the inpatient group and 0.7 days (mean costs of €701) for the day-case group. There were no statistically significant differences in postoperative hospital and out of hospital costs. The QoL at 2 months and 1 year postoperative, measured by the EQ-5D index value and HUI3 showed no statistically significant difference. The EQ-5D VAS score measured at 1 year postoperatively was statistically significantly higher in the inpatient group (84/100) than in the day-case group (65/100). There were no differences in postoperative complications, objective hearing outcomes, and number of postoperative hospital and out of hospital visits.
CONCLUSIONS: A day-case approach to cochlear implant surgery does not result in a statistically significant reduction of health care-related costs compared to an inpatient approach and does not affect the surgical outcome (complications and objective hearing measurements), QoL, and postoperative course (number of postoperative hospital and out of hospital visits).
METHODS:
METHODS: A single-center, non-blinded, randomized controlled trial in a tertiary referral center.
METHODS: Thirty adult patients with post-lingual bilateral sensorineural hearing loss eligible for unilateral cochlear implantation surgery were randomly assigned to either the day-case or inpatient treatment group (i.e., one night admission). We performed an intention-to-treat evaluation of the difference of the total health care-related costs, hospital and out of hospital costs, between day-case and inpatient cochlear implantation, from a hospital and patient perspective over the course of one year. Audiometric outcomes, assessed using CVC scores, and QoL, assessed using the EQ-5D and HUI3 questionnaires, were taken into account.
RESULTS: There were two drop-outs. The total health care-related costs were €41,828 in the inpatient group (n = 14) and €42,710 in the day-case group (n = 14). The mean postoperative hospital stay was 1.2 days (mean costs of €1,069) in the inpatient group and 0.7 days (mean costs of €701) for the day-case group. There were no statistically significant differences in postoperative hospital and out of hospital costs. The QoL at 2 months and 1 year postoperative, measured by the EQ-5D index value and HUI3 showed no statistically significant difference. The EQ-5D VAS score measured at 1 year postoperatively was statistically significantly higher in the inpatient group (84/100) than in the day-case group (65/100). There were no differences in postoperative complications, objective hearing outcomes, and number of postoperative hospital and out of hospital visits.
CONCLUSIONS: A day-case approach to cochlear implant surgery does not result in a statistically significant reduction of health care-related costs compared to an inpatient approach and does not affect the surgical outcome (complications and objective hearing measurements), QoL, and postoperative course (number of postoperative hospital and out of hospital visits).
METHODS:
摘要：
目的：探讨人工耳蜗植入与低成本相关的假设，与住院患者人工耳蜗植入相比，在保持同等生活质量(QoL)和听力结果的同时，荷兰的医疗保健环境。
方法：单中心，非致盲,三级转诊中心的随机对照试验.
方法：将30名符合单侧人工耳蜗植入手术条件的舌后双侧感音神经性耳聋成年患者随机分配到日间或住院治疗组（即，一晚入场)。我们对医疗保健相关总费用的差异进行了意向治疗评估，医院和院外费用，在日间病例和住院人工耳蜗植入之间，从医院和病人的角度来看，在一年的时间里。听力测量结果，使用CVC分数评估，和QoL,使用EQ-5D和HUI3问卷进行评估，被考虑在内。
结果：有两个辍学。住院患者组（n=14）的医疗保健相关总费用为41,828欧元，日间病例组（n=14）为42,710欧元。住院组的平均术后住院时间为1.2天（平均费用为1,069欧元），日间病例组为0.7天（平均费用为701欧元）。术后住院费用和院外费用差异无统计学意义。术后2个月和1年的QoL，测得的EQ-5D指标值与HUI3无统计学差异。住院患者组（84/100）在术后1年测量的EQ-5DVAS评分在统计学上显着高于日间病例组（65/100）。术后并发症无差异,客观的听力结果，以及术后住院次数和院外就诊次数。
结论：人工耳蜗植入手术的日间方法与住院方法相比，在统计学上不会显着降低与医疗保健相关的费用，并且不会影响手术结果（并发症和客观的听力测量）。QoL,和术后病程(术后住院次数和院外就诊次数)。
方法：
方法：单中心，非致盲,三级转诊中心的随机对照试验.
方法：将30名符合单侧人工耳蜗植入手术条件的舌后双侧感音神经性耳聋成年患者随机分配到日间或住院治疗组（即，一晚入场)。我们对医疗保健相关总费用的差异进行了意向治疗评估，医院和院外费用，在日间病例和住院人工耳蜗植入之间，从医院和病人的角度来看，在一年的时间里。听力测量结果，使用CVC分数评估，和QoL,使用EQ-5D和HUI3问卷进行评估，被考虑在内。
结果：有两个辍学。住院患者组（n=14）的医疗保健相关总费用为41,828欧元，日间病例组（n=14）为42,710欧元。住院组的平均术后住院时间为1.2天（平均费用为1,069欧元），日间病例组为0.7天（平均费用为701欧元）。术后住院费用和院外费用差异无统计学意义。术后2个月和1年的QoL，测得的EQ-5D指标值与HUI3无统计学差异。住院患者组（84/100）在术后1年测量的EQ-5DVAS评分在统计学上显着高于日间病例组（65/100）。术后并发症无差异,客观的听力结果，以及术后住院次数和院外就诊次数。
结论：人工耳蜗植入手术的日间方法与住院方法相比，在统计学上不会显着降低与医疗保健相关的费用，并且不会影响手术结果（并发症和客观的听力测量）。QoL,和术后病程(术后住院次数和院外就诊次数)。
方法：
