Although endoscopic intubation is the mainstay of non-surgical palliation of malignant dysphagia, Nd : YAG laser ablation has been shown to provide good palliation with few complications.
The study reported here incorporates data from published and unpublished sources into a cost model which estimates the lifetime cost of palliation with the two therapies.
It is estimated that, depending on the assumptions used, laser palliation costs between £153 and £710 more per patient than endoscopic intubation.
Sensitivity analysis is used to assess whether variation in clinical practice and in the unit costs of resources will change the conclusions of the study.
This indicates that, under most alternative sets of assumptions, intubation retains its cost advantage.
However, factors that might reduce, or even eliminate, this cost differential include undertaking more laser procedures as day-cases, using more expensive expanding metal stents for intubation and reducing the need for follow-up laser procedures with palliative radiotherapy.
Mots-clés Pascal : Dysphagie, Tumeur maligne, Oesophage, Traitement instrumental, Endoscopie, Intubation, Laser YAG, Néodyme, Analyse coût, Economie santé, Traitement palliatif, Traitement, Homme, Oesophage pathologie, Appareil digestif pathologie
Mots-clés Pascal anglais : Dysphagia, Malignant tumor, Esophagus, Instrumentation therapy, Endoscopy, Intubation, YAG laser, Neodymium, Cost analysis, Health economy, Palliative treatment, Treatment, Human, Esophageal disease, Digestive diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0581221
Code Inist : 002B26F. Création : 01/03/1996.