Café recherche – Vendredi 18 février 2022 à 11h en présentiel et en visio

Café recherche – Vendredi 18 février 2022 à 11h en présentiel et en visio

Café recherche – Vendredi 18 février 2022 à 11h en présentiel et en visio

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Dans le cadre des cafés recherche du LIRAES, organisés par Olivier Musy, Sika Dédé Kossi, Doctorante au LIRAES, Université de Paris, présentera une étude intitulée : « Mechanical thrombectomy procedures: Does the payment cover the cost? », co-écrite avec Bertrand Lapergue, Michel Piotin & Pauline Chauvin, le vendredi 18 février 2022 à 11h.

Abstract:
– CONTEXT: The ideal funding system should be able to give incentives for improvement both in quality and in efficiency of care provision while limiting the imbalance of hospital budget and increases in overall costs. This issue was not investigating before concerning innovative medical procedure. 
– OBJECTIVE: This study aimed to investigate the adequacy of the funding of two mechanical thrombectomy (MT) procedures (Stent Retriever (SR) or Contact Aspiration (CA)), used to treat acute ischemic stroke and proven to be cost-effective compared with alternative treatments. For this purpose, we evaluated the difference between the production cost and the payment of these procedures at hospital level and identify the determinants of these differences.
– METHODS: our study was based on a multicenter, prospective randomized controlled clinical trial, ASTER1 (Contact Aspiration vs Stent Retriever for Successful Revascularization). Demographics and health status data on patient and medical resources used during the MT procedure were collected based on a micro-costing approach and valued by their unit costs. Hospital’s characteristics were also collected from the “Statistique Annuelle des Etablissements de santé”. The production cost of MT procedures was then estimated in hospital context and a multiple linear regression with hospital fixed effect specification was performed to identify the determinants of the difference between the procedure cost of MT procedure and its payment. Analyses were performed with STATA software, version 14.
– RESULTS: A total of 349 patients from 8 hospitals were included in the ASTER1 trial: 179 in the CA group and 170 in the SR group. There is no difference in the production cost when CA or SR is used [€6,476 (SD=€1,544) versus €6,473 (SD=€1,317; p=0.9832]. The mean production cost was greater than the mean payment which leads to a mean deficiency of €1,741.11 (SD=€345.74) with CA and of €1,702.79 (SD=€259.86) with SR. 100% of MT procedures were underfunded. Regression results indicated that the presence of diabetes increase the deficiency by €92.7 and that the higher the number of passes, the higher the deficiency. In addition, our results suggested that hospitals with high capacity of personnel and beds would have more deficiency and those who have a greater activity of MT procedures would have lower deficiency.
– CONCLUSIONS: Hospitals would potentially experience a financial loss when producing these efficient and health-improving procedures. This result highlights a potential risk of under provision of mechanical thrombectomy due to funding issues, and the pressing need of enhancing existing funding systems for innovative medical acts.

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Ce séminaire aura lieu =

en présentiel au LIRAES
Université de Paris
Campus Saint Germain
45 rue des Saints Pères – 75006 PARIS
8ème étage (SCFC 1)
(plan d’accès : http://liraes.recherche.parisdescartes.fr/plan-acces/)

&

sur Zoom 
Voici le lien pour participer à la réunion en visioconférence : https://u-paris.zoom.us/j/7188655277?pwd=VXhyY1Zib1Z5M29ndzlvMUtmZ2ZnQT09

La durée de ce séminaire sera d’une heure environ.
ADRESSE
45 rue des Saints Pères - 75006 Paris
TELEPHONE & MAIL
01 42 86 20 71 - liraes.deg@u-paris.fr


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