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The cost-effectiveness of prevention of post-operative thromboembolism

Bergqvist, D ; Mätzsch, Thomas LU ; Jendteg, S ; Lindgren, B and Persson, U (1990) In Acta chirurgica Scandinavica. Supplementum 556. p.36-41
Abstract
In recent years, value for money in health care has become of increasing concern. There are various ways to perform an economic evaluation, the most simple being a cost-effectiveness analysis, where differences in costs will influence the choice between methods. Cost-utility and cost-benefit analyses represent more advanced forms of economic evaluations. In this cost-effectiveness analysis, the following three strategies aimed at solving the problem of post-operative thromboembolic complications were compared: (a) no prophylaxis but treatment of occurring complications, (b) general prophylaxis with low-dose heparin for patients over 40 years of age and (c) selective treatment based on post-operative surveillance with a fibrinogen uptake... (More)
In recent years, value for money in health care has become of increasing concern. There are various ways to perform an economic evaluation, the most simple being a cost-effectiveness analysis, where differences in costs will influence the choice between methods. Cost-utility and cost-benefit analyses represent more advanced forms of economic evaluations. In this cost-effectiveness analysis, the following three strategies aimed at solving the problem of post-operative thromboembolic complications were compared: (a) no prophylaxis but treatment of occurring complications, (b) general prophylaxis with low-dose heparin for patients over 40 years of age and (c) selective treatment based on post-operative surveillance with a fibrinogen uptake test. Moreover, these alternatives were evaluated for three types of surgery: general abdominal surgery, cholecystectomy and elective hip surgery. Costs for thromboembolic and haemorrhagic complications were estimated from data available for patients hospitalized in Malmo. A sensitivity analysis was made with regard to the frequency of thrombosis, prophylactic effect and treatment costs. Health care costs would be minimized with general prophylaxis in hip and general surgery, whereas no prophylaxis is the most cost-effective alternative in cholecystectomy patients, i.e. with a frequency of thrombosis below 8%. General prophylaxis minimized the duration of patients' health losses due to thromboembolic disease in general, as well as in elective hip surgery. After cholecystectomy, no difference in health loss for the individual was found between the alternative of no prophylaxis and general prophylaxis. Selective treatment was always the least satisfactory alternative in all categories and always the most expensive. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta chirurgica Scandinavica. Supplementum
volume
556
pages
36 - 41
publisher
Norstedts Förlag
external identifiers
  • pmid:2126903
  • scopus:0025618949
ISSN
0301-1860
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200)
id
f4b6166f-a486-4777-87f2-79050c0c8940 (old id 1105204)
date added to LUP
2016-04-01 16:47:13
date last changed
2021-01-03 09:02:48
@article{f4b6166f-a486-4777-87f2-79050c0c8940,
  abstract     = {In recent years, value for money in health care has become of increasing concern. There are various ways to perform an economic evaluation, the most simple being a cost-effectiveness analysis, where differences in costs will influence the choice between methods. Cost-utility and cost-benefit analyses represent more advanced forms of economic evaluations. In this cost-effectiveness analysis, the following three strategies aimed at solving the problem of post-operative thromboembolic complications were compared: (a) no prophylaxis but treatment of occurring complications, (b) general prophylaxis with low-dose heparin for patients over 40 years of age and (c) selective treatment based on post-operative surveillance with a fibrinogen uptake test. Moreover, these alternatives were evaluated for three types of surgery: general abdominal surgery, cholecystectomy and elective hip surgery. Costs for thromboembolic and haemorrhagic complications were estimated from data available for patients hospitalized in Malmo. A sensitivity analysis was made with regard to the frequency of thrombosis, prophylactic effect and treatment costs. Health care costs would be minimized with general prophylaxis in hip and general surgery, whereas no prophylaxis is the most cost-effective alternative in cholecystectomy patients, i.e. with a frequency of thrombosis below 8%. General prophylaxis minimized the duration of patients' health losses due to thromboembolic disease in general, as well as in elective hip surgery. After cholecystectomy, no difference in health loss for the individual was found between the alternative of no prophylaxis and general prophylaxis. Selective treatment was always the least satisfactory alternative in all categories and always the most expensive.},
  author       = {Bergqvist, D and Mätzsch, Thomas and Jendteg, S and Lindgren, B and Persson, U},
  issn         = {0301-1860},
  language     = {eng},
  pages        = {36--41},
  publisher    = {Norstedts Förlag},
  series       = {Acta chirurgica Scandinavica. Supplementum},
  title        = {The cost-effectiveness of prevention of post-operative thromboembolism},
  volume       = {556},
  year         = {1990},
}