LAPAROSCOPIC PROCEDURES IN GASTROESOPHAGE AL REFLUX DISEASE - A COST-BENEFIT-ANALYSIS

On the basis of a cost analysis of conservative and surgical therapy o f gastroesophageal reflux disease in 70 patients health economic aspec ts are discussed. In a prospective documented series of reflux patient s a retrolective analysis of medication cost and duration of conservat ive therapy is performed. In addition, the costs for surgical therapy including preoperative diagnostic workup, cost during hospitalization as well as costs for complications with necessary additional treatment and readmissions are assessed. For the conservative treatment of 70 r eflux patients a total of more than DM 700,000 had to be spent during preoperative 5 Sears. A major part of this sum was spent for patients who needed to increase the initial 20 mg dosage of Omeprazol within 5 years. A mean of approximately DM 2,000 per patient was spent for cons ervative treatment. Surgical treatment without complications was calcu lated with DM 5,425 per case. However in 7 patients complications occu rred causing prolonged or even rehospitalization with necessary furthe r treatment summing up to about DM 486,000 for surgical therapy in 70 patients including complications. Cost relevant factors are therefore in conservative treatment patients who need increasing dosages, while, in surgical treatment, the cost relevant patients are those with comp lications and necessary additional treatment.