[Payment by activity and financing of innovative hospital procedures: does the new payment system cover endovascular treatment for cerebral aneurysms?]. / Financement des traitements endovasculaires des anévrysmes cérébraux. La tarification à l'activité permet-elle aux établissements de santé de financer la prise en charge des patients?

METHOD: We have calculated all hospital expenses related to treated intracerebral aneurysms for 2005. Catheters, microcatheters, and guidewires as well as coils were included. We have compared these expenses to the payment by activity and fee per service collected for providing these services. RESULTS: Payments received covered only a third of the expenses for the supplies used. Three types of expenses are not reimbursed: the guiding material, the coils used but not released, and the latest generation of coils not yet added to the national list of covered devices. These expenses are also not covered by the payment received for the hospital admission. DISCUSSION: Endovascular management of intracranial aneurysms has become the treatment of choice over the recent years. This treatment is virtually only available in university hospitals. With the current mode of reimbursement, such treatment generates losses to the hospital. CONCLUSION: This example raises the question of financial support for innovative treatments and procedures.

[Surgical pulmonary biopsies in patients with HIV infection: results apropos of a series of 21 cases]. / Biopsies pulmonaires chirurgicales chez les patients infectés par le VIH: résultats à propos d'une série de 21 cas.

This retrospective study reports the results of surgical lung biopsies in 21 patients infected by HIV. Diagnostic was assessed by surgical lung biopsies in 66% of cases with a 5% immediate post-operative mortality and a 80% survival rate after one month. Therapeutic management was modified in 38% of cases. These results are in concordance with previously published literature and emphasize that such a procedure should only be performed after other diagnostic procedures, including at least a bronchial endoscopy associated to a BAL and/or transbronchial biopsies.