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Outpatient Treatment in Low-Risk Pulmonary Embolism Patients Receiving Direct Acting Oral Anticoagulants Is Associated With Cost Savings

Ghazvinian, Raein LU ; Elf, Johan LU ; Löfvendahl, Sofia LU ; Holst, Jan LU and Gottsäter, Anders LU (2020) In Clinical and Applied Thrombosis/Hemostasis 26.
Abstract

Direct oral anticoagulants (DOAC) are first line treatment for pulmonary embolism (PE). Treatment of acute PE is traditionally hospital based and associated with high costs. The aims of this study were to evaluate potential cost savings with outpatient DOAC treatment compared to inpatient DOAC treatment in patients with low risk PE. A retrospective study in patients with DOAC treated low risk PE (simplified pulmonary severity index [sPESI] ≤ 1) admitted to 8 hospitals during 2013-2015. Health care costs were compared in 223(44%) patients treated as outpatients and 287(56%) treated in hospital. Total cost per patient was 8293 EUR in the inpatient group, and 2176 EUR in the outpatient group (p < 0.001). Total costs for inpatients were... (More)

Direct oral anticoagulants (DOAC) are first line treatment for pulmonary embolism (PE). Treatment of acute PE is traditionally hospital based and associated with high costs. The aims of this study were to evaluate potential cost savings with outpatient DOAC treatment compared to inpatient DOAC treatment in patients with low risk PE. A retrospective study in patients with DOAC treated low risk PE (simplified pulmonary severity index [sPESI] ≤ 1) admitted to 8 hospitals during 2013-2015. Health care costs were compared in 223(44%) patients treated as outpatients and 287(56%) treated in hospital. Total cost per patient was 8293 EUR in the inpatient group, and 2176 EUR in the outpatient group (p < 0.001). Total costs for inpatients were higher (p < 0.001) compared to outpatients in both subgroups with sPESI 0 and 1. In multivariate analysis, type of treatment (in- or outpatient, p = < 0.001) and sPESI group (0 or 1, p = < 0.001) were associated with total cost below or above median, whereas age (p = 0.565) and gender (p = 0.177) was not. Adherence to guidelines recommending outpatient treatment with DOAC in patients with low risk PE enables significant savings.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cost savings, direct oral anticoagulant, inpatient, outpatient, pulmonary embolism, venous thromboembolism
in
Clinical and Applied Thrombosis/Hemostasis
volume
26
publisher
SAGE Publications
external identifiers
  • pmid:33259227
  • scopus:85097029950
ISSN
1076-0296
DOI
10.1177/1076029620937352
language
English
LU publication?
yes
id
e65a5a63-e2bb-48cf-b8a6-79337c700f27
date added to LUP
2020-12-11 12:55:20
date last changed
2024-10-03 14:29:29
@article{e65a5a63-e2bb-48cf-b8a6-79337c700f27,
  abstract     = {{<p>Direct oral anticoagulants (DOAC) are first line treatment for pulmonary embolism (PE). Treatment of acute PE is traditionally hospital based and associated with high costs. The aims of this study were to evaluate potential cost savings with outpatient DOAC treatment compared to inpatient DOAC treatment in patients with low risk PE. A retrospective study in patients with DOAC treated low risk PE (simplified pulmonary severity index [sPESI] ≤ 1) admitted to 8 hospitals during 2013-2015. Health care costs were compared in 223(44%) patients treated as outpatients and 287(56%) treated in hospital. Total cost per patient was 8293 EUR in the inpatient group, and 2176 EUR in the outpatient group (p &lt; 0.001). Total costs for inpatients were higher (p &lt; 0.001) compared to outpatients in both subgroups with sPESI 0 and 1. In multivariate analysis, type of treatment (in- or outpatient, p = &lt; 0.001) and sPESI group (0 or 1, p = &lt; 0.001) were associated with total cost below or above median, whereas age (p = 0.565) and gender (p = 0.177) was not. Adherence to guidelines recommending outpatient treatment with DOAC in patients with low risk PE enables significant savings.</p>}},
  author       = {{Ghazvinian, Raein and Elf, Johan and Löfvendahl, Sofia and Holst, Jan and Gottsäter, Anders}},
  issn         = {{1076-0296}},
  keywords     = {{cost savings; direct oral anticoagulant; inpatient; outpatient; pulmonary embolism; venous thromboembolism}},
  language     = {{eng}},
  publisher    = {{SAGE Publications}},
  series       = {{Clinical and Applied Thrombosis/Hemostasis}},
  title        = {{Outpatient Treatment in Low-Risk Pulmonary Embolism Patients Receiving Direct Acting Oral Anticoagulants Is Associated With Cost Savings}},
  url          = {{http://dx.doi.org/10.1177/1076029620937352}},
  doi          = {{10.1177/1076029620937352}},
  volume       = {{26}},
  year         = {{2020}},
}