PDF(Pubmed)
Abstract：
PIPAC is a new surgical procedure and a viable treatment option for PSM patients, due to promising therapeutic outcomes, minimal invasiveness, limited surgical morbidity, and systemic toxicity side effects. However, its implementation throughout hospitals is hard to obtain due to its fragile economical sustainability. A retrospective health economic analysis was conducted in order to evaluate the cost of hospitalization for patients undergoing PIPAC treatment at Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, in Rome. The average cost of a PIPAC procedure was defined based on the cost of surgery (cost of surgical material, operating room, intraperitoneal chemotherapy), hospital stay, diagnostic examinations, and drugs used during the stay. A total of 493 PIPAC procedures were performed on 222 patients with peritoneal metastases or primary peritoneal cancer from 2017 to 2023. Since the mean remuneration for each PIPAC hospitalization is €5916 and the mean expenditure per hospitalization is €6538, this results in an operating profit per PIPAC hospitalization of -€622. The reimbursement of PIPAC treatment by the Italian National Health System currently only partially covers the hospital\'s costs. Development of specific codes and adequate reimbursement for PIPAC by recognizing this procedure as a proper treatment for peritoneal carcinomatosis is essential.
摘要：
PIPAC是一种新的外科手术和PSM患者的可行治疗选择。由于有希望的治疗结果，最小的侵入性，有限的手术发病率，和全身毒性副作用。然而,由于其脆弱的经济可持续性，它在整个医院的实施是很难获得的。进行了回顾性健康经济学分析，以评估在FondazionePoliclinico大学AgostinoGemelli接受PIPAC治疗的患者的住院费用，IRCCS,在罗马。PIPAC手术的平均成本是根据手术成本(手术材料成本，手术室,腹膜内化疗)，住院,诊断检查,以及逗留期间使用的药物。从2017年到2023年，共对222例腹膜转移或原发性腹膜癌患者进行了493次PIPAC手术。由于每次PIPAC住院的平均薪酬为5916欧元，每次住院的平均支出为6538欧元，因此每次PIPAC住院的营业利润为-622欧元。意大利国家卫生系统对PIPAC治疗的报销目前仅部分支付医院的费用。通过认识到PIPAC是腹膜癌的适当治疗方法，制定特定的代码并为PIPAC提供足够的补偿至关重要。
