Q J Med 2001; 94: 284-285
© 2001 Association of Physicians
Correspondence |
Costs of treating deep-vein thrombosis
Tampere University Hospital and Medical School, University of Tampere, Finland
Sir,
We read with great interest the recent article by O'shaugnessy and colleagues1 which showed that patients with deep-vein thrombosis can be safely treated as out-patients. The authors calculated that an indirect saving of approximately £1800 per patient could be achieved. This prompted us to compare the direct medical costs of out-patient treatment of deep-vein thrombosis to hospital costs.
We started out-patient treatment of deep-vein thrombosis in February 1999. The costs and effectiveness of this treatment (study group) were compared to those treated in hospital immediately prior to February 1999 (control group). Apart from out-patient treatment, no major changes had occurred in treatment policy during the study period. All costs were calculated as they were in November 2000. For in-patient and out-patient care, charges were used as a proxy for direct costs.
The study group comprised 51 women and 49 men, median age 58 years, range 22–92, and the control group 30 women and 20 men, median age 57 years, range 19–93. Half of the patients in the study group were suitable for out-patient treatment. The majority (90%) of out-patients were taught to self-inject, and a telephone line was set up for all out-patients to allow immediate contact if any problems would appear.
Out-patient treatment turned out to be safe, similar to the findings O'shaugnessy and colleagues.1 No major bleeding complications were reported. In both groups, 10% of patients developed pulmonary embolism; one fatal embolism occurred in the control group.
The average hospitalization time was 3.6 days in the study group and 6.5
days in the control group. Table 1
shows the direct treatment costs in both groups. The overall cost saving was £338
per treated patient.
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Our proportion of hospitalized patients was higher than in the study by O'shaugnessy and associates,1 but this was probably due to patient selection. Otherwise, the treatment groups were quite comparable. Our results also show that a high number of patients with deep-vein thrombosis can be treated as out-patients, and that the treatment is not only safe but also cost-efficient.
References
1.
O'shaugnessy D, Miles J, Wimperis W. UK patients
with deep-vein thrombosis can be safely treated as out-patients.
Q J Med2000; 93:
663–7.
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