Cost effectiveness analysis of duration of nonoperative management for adhesive bowel obstruction in a developing country
| Autor: | Olatoke, Samuel, Agodirin, Olayide, Rahman, Ganiyu, Yusuf, Funsho, Adesiyun, Olusola |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis Developing country Tissue Adhesions 030230 surgery Cost Effectiveness Adhesive bowel obstruction non-operative management 03 medical and health sciences 0302 clinical medicine Intestine Small Medicine Humans 030212 general & internal medicine Disease management (health) Nonoperative management Aged Original Research business.industry Disease Management General Medicine Cost-effectiveness analysis Length of Stay Middle Aged medicine.disease Surgery Bowel obstruction Treatment Outcome Cost utility business Developed country Intestinal Obstruction |
| Zdroj: | Malawi Medical Journal Malawi Medical Journal; Vol 30, No 2 (2018); 90-93 |
| ISSN: | 1995-7270 1995-7262 |
| Popis: | Background Adhesive bowel obstruction (ABO) costs billions of dollars in developed countries. Cost is unknown in developing countries. This depends on the type of management and duration of hospital stay. Nonoperative management (NOM) of uncomplicated obstruction is safe for up to 10 days. While it remains cost effective, the most efficient duration of nonoperative management must retain its advantages over operative management. Aim To describe cost effectiveness of various durations of nonoperative management of adhesive obstruction in a developing country. Method Over 2 year period, Patients who had uncomplicated adhesive obstruction were observed on trial of nonoperative management. Length of hospital stay and success rate were combined as surrogates for Cost effectiveness analysis of 2 to 5 days and ≥7 days nonoperative management. Results 41 patients (24(58.5%) females) were eligible. Mean age 38.4 ± 14.7 (range 18-80) years. 31 (75.6%) were first time admissions. The most common previous abdominal operations were for appendix and obstetrics and gynecologic pathologies. Median duration of nonoperative management (dNOM) was 4 days, median LOS was 9 days. Nonoperative management was successful in 53.7% (22 patients). Total estimated direct hospital cost of 41 adhesive bowel obstructions was $133,279. Total personnel charges were $112,142. Mean operative and nonoperative management was $4,914 and $1,814 respectively (p |
| Databáze: | OpenAIRE |
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