ORIGINAL ARTICLE   

Otorhinolaryngology 2022 December;72(4):151-4

DOI: 10.23736/S2724-6302.22.02430-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Sustainability of total laryngectomy in Italy: a cost analysis using the activity-based costing (ABC)

Karim TEWFIK ^{1, 2} ✉, Lazzaro CASSANO ¹, Claudia COVELLI ¹, Maria R. DEL ZOMPO ¹, Chiara COPELLI ^{1, 3}, Nicola PEDERNESCHI ¹, Alfonso MANFUSO ¹, Antonio PANSINI ¹, Francesco LONGO ¹, Roberto COCCHI ¹

¹ Head and Neck Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy; ² Unit of Pediatric Maxillofacial Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; ³ Città della Salute e della Scienza, Turin, Italy

BACKGROUND: Costs and sustainability of the Italian National Health System (NHS) represent increasingly important issues, also in the field of laryngeal cancer surgery. Despite the pressure on clinicians about cost containment and efficiency, in Italy there is still a lack of systems for calculating the real costs incurred for a hospitalization and a comparison with the reimbursement provided by the NHS. The purpose of the current study is to define real cost of a hospitalization for a total laryngectomy and to verify the adequacy of the tariff provided by the Italian NHS in order to define the sustainability of this treatment.
METHODS: Using the Activity Based Costing method, we calculated the mean costs for inpatient stay, surgery and services for a total laryngectomy incurred at Casa Sollievo della Sofferenza Research Hospital (San Giovanni Rotondo, Foggia, Italy) and compared to the refund for the corresponding Diagnosis Related Group (DRG 482 - Tracheostomy for diseases of face, mouth and neck) provided by the Italian NHS consisting of €11,891.
RESULTS: The mean hospitalization cost for a total laryngectomy was €25,848.90, divided into inpatient stay (€9727.40 =38%), surgery (€13,813.70 =53%) and services (€2307.80 =9%).
CONCLUSIONS: The current Italian DRG tariff is not adequate to refund hospitalization cost for total laryngectomy. The refund in use should be updated to guarantee the sustainability of total laryngectomy.

KEY WORDS: Laryngectomy; Costs and cost analysis; Surgery