| Budget Amount *help |
¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 1999: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1998: ¥600,000 (Direct Cost: ¥600,000)
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| Research Abstract |
In this sutudy, the relationship between medical effectiveness and socio-economic benefit of endoscopic treatments such as injection hemostasis with pure ethanol and endoscopic mucosal resection (EMR) were discussed in relation to the average length of hospital stay and the medical cost.
The application of injection hemostasis and intravenous HィイD22ィエD2 blocker antagonists to the bleeding peptic ulcer have been decreased operative cases, and the average length of hospital stay and the medical cost.
EMR cases of superficial esophageal cancer and early gastric cancer the 5-year period were analyzed. The number of cases treated by EMR were increased about 10 times during the 5-year period, while surgical cases were not increased in the same period.
Recently, because EMR is a minimally invasive surgery, nonoperative cases with severely complicated disease have been treated by EMR rather than operation. In EMR cases of superficial esophageal cancer, the average length of stay is about one fourth shorter compared with that by surgical operation. In addition, the treatment cost of EMR also is much lower than that of surgical operation. Only for EMR cases with severely complicated diseases and aged patients over the age of 65, the average length of stay after EMR was increased.
Considering the economical declining and aging society in our country, it is necessary to standardize clinical medicine and special treatment such as EMR as the standardization of DRG(Diagnosis Related Group)/PPS(Prospective Payment System) in the U.S.A.. The standardization of endoscopy by the JGES (Japan Gastro-intestinal Endoscopy Society) could be useful for the renewal of the national health insurance system in Japan.
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