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An economic evaluation of outpatient versus inpatient polyp treatment for abnormal uterine bleeding.
- Source :
-
BJOG: An International Journal of Obstetrics & Gynaecology . Mar2016, Vol. 123 Issue 4, p625-631. 7p. 3 Charts, 1 Graph. - Publication Year :
- 2016
-
Abstract
- <bold>Objectives: </bold>To undertake a cost-effectiveness analysis of outpatient uterine polypectomy compared with standard inpatient treatment under general anaesthesia.<bold>Design: </bold>Economic evaluation carried out alongside the multi-centre, pragmatic, non-inferiority, randomised controlled Outpatient Polyp Treatment (OPT) trial. The UK National Health Service (NHS) perspective was used in the estimation of costs and the interpretation of results.<bold>Setting: </bold>Thirty-one secondary care UK NHS hospitals between April 2008 and July 2011.<bold>Participants: </bold>Five hundred and seven women with abnormal uterine bleeding and hysteroscopically diagnosed endometrial polyps.<bold>Interventions: </bold>Outpatient uterine polypectomy versus standard inpatient treatment. Clinicians were free to choose the technique for polypectomy within the allocated setting.<bold>Main Outcome Measures: </bold>Patient-reported effectiveness of the procedure determined by the women's self-assessment of bleeding at 6 months, and QALY gains at 6 and 12 months.<bold>Results: </bold>Inpatient treatment was slightly more effective but more expensive than outpatient treatment, resulting in relatively high incremental cost-effectiveness ratios. Intention-to-treat analysis of the base case at 6 months revealed that it cost an additional £9421 per successfully treated patient in the inpatient group and £ 1,099,167 per additional QALY gained, when compared with outpatient treatment. At 12 months, these costs were £22,293 per additional effectively treated patient and £445,867 per additional QALY gained, respectively.<bold>Conclusions: </bold>Outpatient treatment of uterine polyps associated with abnormal uterine bleeding appears to be more cost-effective than inpatient treatment at willingness-to-pay thresholds acceptable to the NHS.<bold>Tweetable Abstract: </bold>HTA-funded OPT trial concluded that outpatient uterine polypectomy is cost-effective compared with inpatient polypectomy. [ABSTRACT FROM AUTHOR]
- Subjects :
- *POLYPS
*UTERINE hemorrhage treatment
*ENDOMETRIAL diseases
*HYSTEROSCOPY
*OUTPATIENT medical care research
*COST effectiveness
*THERAPEUTICS
*COMPARATIVE studies
*OUTPATIENT medical care
*GYNECOLOGIC surgery
*HOSPITAL care
*RESEARCH methodology
*MEDICAL care research
*MEDICAL care costs
*MEDICAL cooperation
*PATIENT satisfaction
*RESEARCH
*UTERINE hemorrhage
*COST analysis
*EVALUATION research
*RANDOMIZED controlled trials
*TREATMENT effectiveness
*DISEASE complications
*SURGERY
*ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 14700328
- Volume :
- 123
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 113307907
- Full Text :
- https://doi.org/10.1111/1471-0528.13434