Journal
BRITISH JOURNAL OF NEUROSURGERY
Volume 15, Issue 3, Pages 221-227Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/02688690120057637
Keywords
cerebrospinal fluid shunt; cost analysis; hydrocephalus; pressure adjustable valve; programmable Medos Hakim valve
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Based on a retrospective study in which a total of 541 Codman Hakim Programmable Valves (CHPV) were implanted in 477 patients over a 6-year period, this cost analysis was performed. By using a valve with an adjustable opening pressure, valve exchange to alter the opening pressure and surgical evacuation of subdural haematomas and hygromas can be avoided. Dividing the added cost for using the CHPV by the cost of implanting a non-programmable Hakim valve results in 105.8 valve exchanges, which would have had to be avoided to break even financially. On 107 occasions a valve was adjusted by a magnitude of 50 mmH(2)O or more. This, if an adjustment of that magnitude is said to correspond to a valve exchange, is sufficient to break even. The analysis suggests that the extra cost of the valve is outweighed by the ability to adjust the opening pressure setting non-invasively.
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