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Economics of Hernia Repair

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Management of Abdominal Hernias

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Abstract

Hernia repair is one of the most frequently performed surgical procedures in the developed world with over 700,000 being performed each year in both the USA and Europe. Few surgical procedures have been as intensively evaluated as surgical methods for hernia repair. In recent years, there have been many high quality randomized controlled trials and several rigorous systematic reviews and meta-analyses (the recent European Hernia Society guideline provides, at the time of writing, one of the most up to date of reviews and meta-analyses) [1]. Almost uniquely for surgical interventions, there also have been a considerable number of economic evaluations performed. Some of these have been conducted as part of randomized controlled trials, and there have been several attempts to systematically review them [2–4]. In this chapter, evidence has been drawn from one of these evaluations [3], which was used to inform policy recommendations made by the National Institute for Health and Clinical Excellence (NICE) [5] and the European Hernia Society guidelines [1].

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Notes

  1. 1.

    In this analysis, the statistical precision of estimates has also been presented. Ideally this statistical precision should also be included for other forms of economic evaluation but has been omitted thus far to simplify presentation of key issues.

  2. 2.

    The two most popular methods, Fieller’s approach and the nonparametric bootstrap approach, are discussed by Briggs (2004).

  3. 3.

    The DCE study was carried out at two centers in London and Glasgow. The sample of patients was identified from hospital records as having had an hernia repair in the past. In total, 658 patients were identified, the majority of those had been involved in the two UK-based trials.13,24 The response rate to the questionnaires was 49% (320/658), which is usual in these types of studies.19

References

  1. European Hernia Society Guidelines. Treatment of inguinal hernia in adult patients. 2009. http://www.herniaweb.org.

  2. Vale L, Grant A, Ludbrook A. Assessing the costs and consequences of laparoscopic versus open methods of groin hernia repair: a systematic review. Surg Endosc. 2003;17:844–9.

    Article  PubMed  CAS  Google Scholar 

  3. McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E, Vale L, Grant A. Systematic review of the clinical effectiveness and cost-effectiveness of laparoscopic surgery for inguinal hernia repair. Health Technol Assess. 2005;9(14):1–203. iii-iv.

    PubMed  CAS  Google Scholar 

  4. Gholghesaei M, Langeveld H, Veldkamp R, Bonjer H. Costs and quality of life after endoscopic repair of inguinal hernia vs. open tension-free repair: a review. Surg Endosc. 2005;19:816–21.

    Article  PubMed  CAS  Google Scholar 

  5. National Institute for Clinical Excellence. Laparoscopic Surgery for inguinal hernia repair. Technology Appraisal 83. 2004. http://www.nice.org.uk/pdf/TA083guidance.pdf. National Institute for Clinical Excellence.

  6. BayNielsen M, Perkins F. Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg. 2001;233:1–7.

    Article  CAS  Google Scholar 

  7. Callesen T, Bech K, Kehlet H. Prospective study of chronic pain after groin hernia repair. Br J Surg. 1999;86:1528–31.

    Article  PubMed  CAS  Google Scholar 

  8. Courtney CA. Outcome of patients with severe chronic pain ­following repair of groin. Br J Surg. 2002;89:1310–4.

    Article  PubMed  CAS  Google Scholar 

  9. Felix EL, Harbertson N, Vartanian S. Laparoscopic hernioplasty: significant complications. Surg Endosc. 1999;13:328–31.

    Article  PubMed  CAS  Google Scholar 

  10. Drummond MF, O’Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 1997.

    Google Scholar 

  11. Auld C, Donaldson C, Mitton C, Shackley P. Economic evaluation. In: Detels R, Holland W, Omenn G, editors. Oxford textbook of public health. Oxford: Oxford University Press; 2001.

    Google Scholar 

  12. Fox Rushby J, Cairns J, editors. Economic evaluation. Understanding public health. Maidenhead: Open University Press; 2005.

    Google Scholar 

  13. MRC Laparoscopic Groin Hernia Trial Group. Cost-utility analysis of open versus laparoscopic groin hernia repair: results from a multicentre randomized clinical trial. Br J Surg. 2001;88:653–61.

    Article  Google Scholar 

  14. Kind P, Hardman G, Macran S. UK Population Norms for EQ-5D. Centre for Health Economics Discussion Paper; 1999. p. 172.

    Google Scholar 

  15. Donaldson C, Mason H, Shackley P. Contingent valuation in health care. In: Jones A, editor. The Elgar companion to health economics. Cheltenham: Elgar; 2006.

    Google Scholar 

  16. Ryan M. Methodological issues in the monetary valuation of benefits in healthcare. Expert Rev Pharmacoecon Outcomes Res. 2003;3:717–2739.

    Article  PubMed  Google Scholar 

  17. Ryan M, et al. Using discrete choice experiments in health economics. In: Jones A, editor. The Elgar companion to health economics. Bodmin: MPG Books; 2006.

    Google Scholar 

  18. Louviere J, et al. Stated choice methods: analysis and application. Cambridge: Cambridge University Press; 2000.

    Book  Google Scholar 

  19. Ryan M, Gerard K. Using discrete choice experiments to value health care programmes: current practice and future research reflections. Appl Health Econ Health Policy. 2003;2:55–64.

    PubMed  Google Scholar 

  20. National Institute for Health and Clinical Excellence Guide to the Methods of Technology Appraisal http://www.nice.org.uk/aboutnice/howwework/devnicetech/technologyappraisalprocessguides/guidetothemethodsoftechnologyappraisal.jsp

  21. Briggs A, O’Brien B. The death of cost-minimization analysis. Health Econ. 2001;10:179–84.

    Article  PubMed  CAS  Google Scholar 

  22. Briggs A. Statistical approaches to handling uncertainty in health economic evaluation. Eur J Gastroenterol Hepatol. 2004;16:551–61.

    Article  PubMed  Google Scholar 

  23. Wellwood J, Sculpher M, Stoker D, Nicholls G, Geddes C, Whitehead A, Singh R, Spiegelhalter D. Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. Br Med J. 1998;317:103–10.

    Article  CAS  Google Scholar 

  24. Lau H. Learning curve for unilateral endoscopic totally extraperitoneal (TEP) inguinal hernioplasty. Surg Endosc. 2002;16:1724–8.

    Article  PubMed  CAS  Google Scholar 

  25. Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons Jr R, Dunlop D, Gibbs J, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med. 2004;350:1819–27.

    Article  PubMed  CAS  Google Scholar 

  26. Wright D, Paterson C, Scott N, Hair A, O’Dwyer PJ. Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg. 2002;235(3):333–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

    Luke Vale

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  1. Luke Vale
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Correspondence to Luke Vale .

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Editors and Affiliations

  1. , Department of Surgery, Peninsula College of Medicine & Dentistr, N/A, Plymouth, PL4 8AA, Devon, United Kingdom

    Andrew N. Kingsnorth

  2. , Surgeons Group of Baton Rouge, Our Lady of the Lake Physician Group, N/A, Baton Rouge, 70808, Louisiana, USA

    Karl A. LeBlanc

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Vale, L. (2013). Economics of Hernia Repair. In: Kingsnorth, A., LeBlanc, K. (eds) Management of Abdominal Hernias. Springer, London. https://doi.org/10.1007/978-1-84882-877-3_5

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  • DOI: https://doi.org/10.1007/978-1-84882-877-3_5

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