TY - T1的卫生保健系统费用与手术和医学治疗耐药性癫痫患儿在安大略省JF -神经学乔-神经病学SP - e1204 LP - e1215做- 10.1212 / WNL。首页0000000000200026六世- 98 - 12盟Elysa Widjaja盟-林赛Demoe AU -奥马尔Yossofzai盟-阿斯特丽德古德曼爵士AU -乔治·汤姆林森盟詹姆斯Rutka AU - o·卡特大镰刀刀柄盟Beate桑德Y1 - 2022/03/22 UR - //www.ez-admanager.com/content/98/12/e1204.abstract N2 -背景和目标改善癫痫控制癫痫手术后可能会导致首页医疗资源利用和成本降低,但这是不确定这是否可以抵消高成本与手术有关。本研究旨在评估分阶段和累积长期医疗成本的手术相比,药物治疗耐药性癫痫患儿的医疗付款人的视角。孩子们评估方法与手术或药物治疗癫痫手术和治疗从2003年到2018年在多伦多儿童医院标识图审查和与他们的健康管理数据库在安大略省,加拿大。治疗逆概率权重与稳定权重是用来平衡之间的基线共2组。受试者被分配到presurgery、手术、短期(前两年),中期(2 - 5年)和长期(在5年)护理阶段的基础上治疗时间均轨迹。分阶段和累积长期医疗成本进行评估。成本是2018年从加拿大到美元价值转换。结果有372例手术,258病人。手术的成本高于医疗病人presurgery(3和39周),手术,和短期护理阶段,和手术的可归属成本每7 patient-days为1602美元(95% CI 1438 - 1785美元),172美元(95% CI 147 - 185美元),19819美元(95% CI 18822 - 20932美元),和28美元(95% CI 22 - 32美元),分别。成本是降低手术患者中长期保健阶段,和由于成本−72美元(95% CI−−35美元124美元)和−94美元(95% CI−−129美元63美元),分别。 In surgical patients, costs were highest for surgery followed by presurgery care phase, with hospitalizations accounting for the highest cost component. In medical patients, costs increased gradually from presurgery to long-term care phase. Cumulative costs were higher for surgical than medical patients in the first 7 years after surgery, but from 8 years on, costs were lower for surgical patients.Discussion This study demonstrated the long-term economic benefits of epilepsy surgery compared to medical therapy for the health care system with the use of real-world data, which would justify the high costs of surgery. The results will support future economic evaluation comparing minimally invasive treatment such as laser therapy to surgery.DRE=drug-resistant epilepsy; ED=emergency department; MOH=Ministry of Health; MRgLITT=magnetic resonance–guided laser interstitial thermal therapy ER -