E. Sechet, B. Lefranc, R. Guilé, F. Duteille, K. Sellal
{"title":"Étude de coût d’un dispositif médical innovant : l’agrafeuse sous-cutanée à agrafes résorbables","authors":"E. Sechet, B. Lefranc, R. Guilé, F. Duteille, K. Sellal","doi":"10.1016/J.PHHP.2010.04.010","DOIUrl":"https://doi.org/10.1016/J.PHHP.2010.04.010","url":null,"abstract":"","PeriodicalId":100871,"journal":{"name":"Le Pharmacien Hospitalier","volume":"252 1","pages":"72-78"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76319895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Séchet , B. Lefranc , R. Guilé , F. Duteille , K.-O. Sellal
{"title":"Étude de coût d’un dispositif médical innovant : l’agrafeuse sous-cutanée à agrafes résorbables","authors":"E. Séchet , B. Lefranc , R. Guilé , F. Duteille , K.-O. Sellal","doi":"10.1016/j.phhp.2010.04.010","DOIUrl":"https://doi.org/10.1016/j.phhp.2010.04.010","url":null,"abstract":"<div><p>Une nouvelle agrafeuse chirurgicale utilisant des agrafes résorbables est commercialisée depuis quelques mois. Ce dispositif permettrait d’allier les avantages d’une suture résorbable à ceux d’une suture mécanique pour la fermeture sous-cutanée. Au CHU de Nantes, un suivi spécifique de l’utilisation de cette agrafeuse a été mis en place en chirurgie plastique, durant cinq mois en 2008. Nous avons réalisé une évaluation financière afin de déterminer si le surcoût engendré par ce nouveau matériel pouvait être pris en charge par l’établissement. Le coût de revient de chaque type de séjour avec utilisation de cette agrafeuse a été calculé, puis comparé au montant du remboursement obtenu par l’établissement. Le surcoût induit par ce matériel ne déséquilibre pas la structure de coût des séjours étudiés. Son absorption peut être envisagée par une réduction des durées moyennes de séjours, une augmentation de l’activité opératoire et par l’optimisation des remboursements liée à la nouvelle campagne tarifaire 2009. D’un point de vue clinique, la supériorité de cette nouvelle technique de suture n’est pas formellement démontrée. Si un gain de temps lors de l’acte opératoire a bien été identifié, les données concernant l’efficacité et la tolérance des agrafes résorbables doivent être complétées par de nouvelles études.</p></div><div><p>A new surgical stapler with absorbable staples for subcuticular closure is available for few months. This device could combine the advantages of absorbable suture with those of a mechanical system. In Nantes University Hospital, we conducted an economic assessment by monitoring use of this stapler in Plastic Surgery area during 5<!--> <!-->months in 2008. The aim of the study was to determine the hospital ability to support additional costs for this new medical device. We calculated the cost of each hospitalization with use of the stapler and we compared it to the reimbursement received by the institution. The economic framework of the studied hospitalizations was unchanged by the additional cost induced by the absorbable dermal stapler. With a reduction of average lengths of stays, a surgical activity increase and a reimbursement's optimization due to the new rates in 2009, use of this stapler in our institution could be cost effective. From a clinical perspective, the superiority of this new suture technique is not formally proven. If saving time during closure procedures has been well highlighted, data on efficacy and tolerance of staples must be assessed by further studies.</p></div>","PeriodicalId":100871,"journal":{"name":"Le Pharmacien Hospitalier","volume":"45 2","pages":"Pages 72-78"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.phhp.2010.04.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72248629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Le dispositif médical, A. Audry, J.-C. Ghislain. Presses universitaires de France, Paris (2009). 128 pp., 9 €, ISBN 978-2-13-057393-7.","authors":"B. Édouard","doi":"10.1016/J.PHHP.2010.04.004","DOIUrl":"https://doi.org/10.1016/J.PHHP.2010.04.004","url":null,"abstract":"","PeriodicalId":100871,"journal":{"name":"Le Pharmacien Hospitalier","volume":"161 1","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73649053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Bennani , S. Wisniewski , L. Beretz , S. Chassagnon
{"title":"Surgical treatment of drug-resistant epilepsy, University Hospital of Strasbourg","authors":"A. Bennani , S. Wisniewski , L. Beretz , S. Chassagnon","doi":"10.1016/j.phhp.2010.05.004","DOIUrl":"10.1016/j.phhp.2010.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>Surgical treatment of drug-resistant epilepsy is the last resort to reduce or completely cure epilepsy. The objectives of this study were firstly, to study the different profiles and postoperative complications for patients managed at our institution and also to estimate the cost of explorative study by stereoelectroencephalographic electrodes (SEEG).</p></div><div><h3>Method</h3><p>A retrospective study was conducted on patients operated between 2003 and 2008 and followed by the Neurology Department.</p></div><div><h3>Results</h3><p>A total of 104 medical records were analyzed. The average patient age at surgery was 34 years (range 10–70 years) and mean duration of epilepsy before surgery 21 years (range: 3–56 years). In 80% of cases, type temporal epilepsy was encountered, mainly treated by temporal resection (72%). One year after surgery, 60% of patients were seizure-free(Engel class I), 62% of the patients could resume their work or school and 26% of patients had permanent postoperative complications, minor and expected in the majority of them; no deaths have been reported.</p></div><div><h3>Discussion/conclusion</h3><p>Two types of medical devices are used in the management of epilepsy surgery: the left vagus nerve stimulation (8900 € paid besides hospital benefits) and the electrodes of stereo-electroencephalography (SEEG) in possible prior to conventional surgery. Having introduced the use of SEEG electrodes in our institution in 2004, for epilepsy surgery an average of 11 electrodes (eight to 15 electrodes) is required at an average cost of €<!--> <!-->4284 per patient. These electrodes represent 58% of average tariff, of the disease-related groups found among patients (€<!--> <!-->7418). In our study, epilepsy surgery appears to be of significant clinical benefit. However, the cost-effectiveness of conventional surgery for epilepsy post-SEEG must be reevaluated to confirm the long-term interest.</p></div><div><h3>Objectif</h3><p>Le traitement chirurgical de l’épilepsie pharmacorésistante constitue le dernier recours vers la réduction, voire la guérison totale de l’épilepsie. Les objectifs de ce travail étaient, d’une part, d’étudier les différents profils et les complications postopératoires des patients pris en charge dans notre établissement et, d’autre part, d’estimer le coût des explorations par les électrodes de stéréo-électroencéphalographie (SEEG).</p></div><div><h3>Méthode</h3><p>Une étude rétrospective a été menée sur les patients opérés entre 2003 et 2008 et suivis par le service de neurologie.</p></div><div><h3>Résultats</h3><p>Au total, 104 dossiers médicaux ont été analysés. La moyenne d’âge des patients lors de l’intervention était de 34 ans (extrêmes : 10–70 ans) et la durée moyenne de l’épilepsie avant l’opération de 21 ans (extrêmes : 3–56 ans). Dans 80 % des cas, l’épilepsie rencontrée était de type temporal, principalement traitée par une résection temporale (72 %). Un an après la chirurgie, 6","PeriodicalId":100871,"journal":{"name":"Le Pharmacien Hospitalier","volume":"45 2","pages":"Pages e1-e5"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.phhp.2010.05.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"104556219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}