Alexandria Bennett1, Kednapa Thavorn2, Kristina Arendas1, Doug Coyle1, Sukhbir S Singh1. 1. Clinical Epidemiology Program (Bennett, Thavorn), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Bennett, Thavorn, Arendas, Coyle, Singh), University of Ottawa; ICES uOttawa (Thavorn); Department of Obstetrics, Gynecology, and Newborn Care (Arendas, Singh), The Ottawa Hospital, Ottawa, Ont. 2. Clinical Epidemiology Program (Bennett, Thavorn), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Bennett, Thavorn, Arendas, Coyle, Singh), University of Ottawa; ICES uOttawa (Thavorn); Department of Obstetrics, Gynecology, and Newborn Care (Arendas, Singh), The Ottawa Hospital, Ottawa, Ont. kthavorn@ohri.ca.
Abstract
BACKGROUND: Most often in Canada, the evaluation and management of abnormal uterine bleeding occurs under general anesthesia in the operating room. We aimed to assess the potential cost-effectiveness of an outpatient uterine assessment and treatment unit (UATU) compared with the current standard of care when diagnosing and treating abnormal uterine bleeding in women. METHODS: We performed a cost-effectiveness analysis and developed a probabilistic decision tree model to simulate the total costs and outcomes of women receiving outpatient UATU or usual care over a 1-year time horizon (Apr. 1, 2014, to Mar. 31, 2017) at a tertiary care hospital in Ontario, Canada. Probabilities, resource use and time to diagnosis and treatment were obtained from a retrospective chart review of 200 randomly selected women who presented with abnormal uterine bleeding. Results were expressed as overall cost and time savings per patient. Costs are reported in 2018 Canadian dollars. RESULTS: Compared with usual care, care in the UATU was associated with a decrease in overall cost ($1332, 95% confidence interval [CI] -$1742 to -$1008) and a decrease in overall time to treatment (-75, 95% CI -89 to -63, d). The point at which the UATU would no longer be cost saving is if the additional cost to operate and maintain the UATU is greater than $1600 per patient. INTERPRETATION: From the perspective of Canada's health care system, an outpatient UATU is more cost effective than usual care and saves time. Future studies should focus on the relative efficacy of a UATU and the total budget required to operate and maintain a UATU. Copyright 2020, Joule Inc. or its licensors.
BACKGROUND: Most often in Canada, the evaluation and management of abnormal uterine bleeding occurs under general anesthesia in the operating room. We aimed to assess the potential cost-effectiveness of an outpatient uterine assessment and treatment unit (UATU) compared with the current standard of care when diagnosing and treating abnormal uterine bleeding in women. METHODS: We performed a cost-effectiveness analysis and developed a probabilistic decision tree model to simulate the total costs and outcomes of women receiving outpatientUATU or usual care over a 1-year time horizon (Apr. 1, 2014, to Mar. 31, 2017) at a tertiary care hospital in Ontario, Canada. Probabilities, resource use and time to diagnosis and treatment were obtained from a retrospective chart review of 200 randomly selected women who presented with abnormal uterine bleeding. Results were expressed as overall cost and time savings per patient. Costs are reported in 2018 Canadian dollars. RESULTS: Compared with usual care, care in the UATU was associated with a decrease in overall cost ($1332, 95% confidence interval [CI] -$1742 to -$1008) and a decrease in overall time to treatment (-75, 95% CI -89 to -63, d). The point at which the UATU would no longer be cost saving is if the additional cost to operate and maintain the UATU is greater than $1600 per patient. INTERPRETATION: From the perspective of Canada's health care system, an outpatientUATU is more cost effective than usual care and saves time. Future studies should focus on the relative efficacy of a UATU and the total budget required to operate and maintain a UATU. Copyright 2020, Joule Inc. or its licensors.
Authors: Richard J A Penketh; Elizabeth M Bruen; Judith White; Anthony N Griffiths; Asmita Patwardhan; Peter Lindsay; Sarah Hill; Grace Carolan-Rees Journal: J Minim Invasive Gynecol Date: 2014-03-26 Impact factor: 4.137
Authors: R Campo; F Santangelo; S Gordts; C Di Cesare; H Van Kerrebroeck; M C De Angelis; A Di Spiezio Sardo Journal: Facts Views Vis Obgyn Date: 2018-09