Clinical and health costs impact of progress in diagnosis and treatment in venous thromboembolic disease: evolution in 15 years
| Autor: | Silvia Lozano-Alonso, Alejandra Bravo-Molina, E. Ros-Díe, Blanca Vera-Arroyo, José Patricio Linares-Palomino, Juan Jose Moreno-Villalonga |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Deep vein Cost-Benefit Analysis Venography MEDLINE Drug Costs Fibrin Fibrinogen Degradation Products Therapeutic approach Venous thromboembolic disease Cost Savings Predictive Value of Tests medicine Humans Registries Hospital Costs Aged Inpatients medicine.diagnostic_test business.industry Anticoagulants General Medicine Phlebography Venous Thromboembolism Heparin Low-Molecular-Weight Length of Stay Middle Aged medicine.disease Thrombosis Surgery medicine.anatomical_structure Models Economic Treatment Outcome Predictive value of tests Emergency medicine Observational study Female Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Annals of vascular surgery. 27(8) |
| ISSN: | 1615-5947 |
| Popis: | Background The therapeutic and diagnostic approach in deep vein thrombosis (DVT) has changed enormously in the last two decades with the introduction of ultrasound, low-molecular-weight heparin (LMWH), and premature motion. The aim of this study is to evaluate these changes and analyze their clinical and economic aspects. Methods We registered all inpatients with a diagnosis of DVT during 1994 (n = 110) and 2009 (n = 75) and their sociodemographic and clinical features in a descriptive observational design. We performed a comparison of diagnostic techniques, length of stay, inpatient complications, and costs thus derived for both series, based on 2009 prices, so that we could get comparable results. Results Ninety-one percent of inpatients in 1994 were diagnosed by venography, whereas, in 2009, the diagnosis was based on clinical features, D-dimer, and ultrasound in 100% of patients. Inpatient treatment went from 7% LMWH in 1994 to 96% in 2009, and as outpatient from 82% acenocumarol to 90.6% LMWH. Complications decreased by 13.3%. Length of stay was 2.7 higher in 1994. Globally, the cost per patient decreased by 63.39%, based primarily on reduced length of stay. Conclusions The current diagnostic and therapeutic approach in DVT allows for effective treatment, fewer complications, and a drastic reduction in inpatient costs. |
| Databáze: | OpenAIRE |
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