Two clinical trials in patients with acute deep venous thrombosis have indicated that the outpatient management with fixed-dose, subcutaneous low-molecular-weight heparin is at least as effective and safe as inpatient treatment with unfractionated intravenous heparin with respect to recurrent venous thromboembolism and major bleeding.
We performed an economic evaluation alongside one of these trials to assess the cost consequences of the outpatient management strategy.
Data were collected through case record forms, complemented by a prospective questionnaire in 78 consecutive patients, interviews with health care providers, and hospital data bases.
Our study demonstrated that seventy-five percent of patients allocated to low-molecular-weight heparin received treatment either entirely at home or after a brief hospital stay.
Fifteen percent of these patients required professional domiciliary care.
Within-centre comparisons of resource utilisation in terms of natural units showed that outpatient management with low-molecular-weight heparin reduced the average number of hospital days in the initial treatment period in nine centres by 59 percent (95% CI : 43 to 71 percent) accompanied by a limited increase in outpatient and professional domiciliary care.
The average reduction in hospital days at the end of follow up was 40 percent (95% CI : 25 to 54 percent). (...)
Mots-clés Pascal : Thrombose profonde, Veine, Anticoagulant, Héparine, Héparine bas poids moléculaire, Chimiothérapie, Traitement, Ambulatoire, Analyse coût, Economie santé, Europe, Australie, Océanie, Nouvelle Zélande, Homme, Glycosaminoglycane, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Veine pathologie
Mots-clés Pascal anglais : Deep vein thrombosis, Vein, Anticoagulant, Heparin, Low molecular weight heparin, Chemotherapy, Treatment, Ambulatory, Cost analysis, Health economy, Europe, Australia, Oceania, New Zealand, Human, Glycosaminoglycan, Cardiovascular disease, Vascular disease, Venous disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0120070
Code Inist : 002B02G. Création : 22/06/1998.