脳動脈瘤治療の入院医療費

―コイル塞栓術とクリッピング術との比較―

抄録

We sought to compare medical costs of coiling and clipping for treatment of cerebral aneurysms. Data of total medical costs for coiling and clipping from 2006 to 2009 were retrieved from the medical reimbursement database at Teikyo University Hospital. There were 32 and 29 cases, respectively, for coiling and clipping of ruptured aneurysm who presented with subarachnoid hemorrhage, and 41 cases each with unruptured aneurysms for coiling and clipping. In patients with ruptured aneurysms, basic hospitalization costs were lower in the coiling group even with higher device-related costs. As a result, total medical costs during hospitalization were equivalent between the coiling and clipping groups. In patients with unruptured aneurysms, however, total medical costs during hospitalization were much higher in the coiling group than those in the clipping group. The difference in an amount of basic hospital costs was not enough to absorb the higher device-related costs in the coiling groups due to relatively shorter length of hospital stays in patients with unruptured aneurysms.
Medical costs for treatment of cerebral aneurysms are well balanced between coiling and clipping in patients with subarachnoid hemorrhage. Coiling of unruptured aneurysms, however, pushes up the total amount of medical costs significantly due to higher device-related costs compared with clipping.