Clinical trial NCT03504878: Cost-effectiveness Analysis and Case-based Payment Norm Modeling on Appendicitis Patients at Hanoi Medical University Hospital
Official title: Cost-effectiveness Analysis and Case-based Payment Norm Modeling on Appendicitis Patients at Hanoi Medical University Hospital
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Acute Appendicitis
Lead sponsor: Hanoi Medical University
Sponsor class: OTHER
First posted: 2018-04-20
Enrollment: 322
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Adult patients with clinical, laboratory, and radiological signs of acute appendicitis

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

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

Primary outcomes:
measure: Average cost of hospitalization based on the final hospital bills
timeFrame: 2 years
measure: Average Cost of medication
timeFrame: 2 years
measure: Overall treatment cost of acute appendicitis patient
timeFrame: From the beginning of hospital admission till discharge from hospital ((an expected average of 10 days, maximum 20 days)
measure: Case-based cost of appendectomy
timeFrame: 2 years
measure: Cost of appendectomy based on health care services fee
timeFrame: 2 years
Secondary outcomes:
measure: Length of hospital stay
timeFrame: from the beginning of the surgery till discharge from hospital (an expected average of 8 days, maximum 20 days)
measure: Duration of post-operative pain
timeFrame: from the beginning of the surgery till discharge from hospital (an expected average of 8 days, maximum 20 days)
measure: Degree of post-operative pain
timeFrame: from the beginning of the surgery till discharge from hospital (an expected average of 8 days, maximum 20 days)
measure: Time until resumption of clear liquid and regular diet
timeFrame: from the beginning of the surgery to the resumption (an expected average 2 days after the surgery
measure: Surgical outcome at hospital discharge
timeFrame: 2 years
Other outcomes:
Locations:
city: Hanoi
country: Vietnam
facility: Hanoi Medical University
Study officials:
References: