Comparison of an anticoagulation clinic with usual medical care : Anticoagulation control, patient outcomes, and health care costs.
The outcomes of an inception cohort of patients seen at an anticoagulation clinic (AC) were published previously.
The temporary closure of this clinic allowed the evaluation of 2 more inception cohorts : usual medical care and an AC.
To compare newly anticoagulated patients who were treated with usual medical care with those treated at an AC for patient characteristics, anticoagulation control, bleeding and thromboembolic events, and differences in costs for hospitalizations and emergency department visits.
Rates are expressed as percentage per patient-year.
Patients treated at an AC who received lower-range anticoagulation had fewer international normalized ratios greater than 5.0 (7.0% vs 14.7%), spent more time in range (40.0% vs 37.0%), and spent less time at an international normalized ratio greater than 5 (3.5% vs 9.8%). Patients treated at an AC who received higher-range anticoagulation had more international normalized ratios within range (50.4% vs 35.0%), had fewer international normalized ratios less than 2.0 (13.0% vs 23.8%), and spent more time within range (64.0% vs 51.0%). The AC group had lower rates (expressed as percentage per patient-year) of significant bleeding (8.1% vs 35.0%), major to fatal bleeding (1.6% vs 3.9%), and thromboembolic events (3.3% vs 11.8%) ; the AC group also demonstrated a trend toward a lower mortality rate (0% vs 2.9% ; P=09). (...)
Mots-clés Pascal : Anticoagulant, Résultat, Coût, Soin, Hospitalisation, SAMU, Chimiothérapie, Etude cohorte, Traitement, Economie, Homme, Etude comparative, Revue bibliographique
Mots-clés Pascal anglais : Anticoagulant, Result, Costs, Care, Hospitalization, Emergency medical care unit, Chemotherapy, Cohort study, Treatment, Economy, Human, Comparative study, Bibliographic review
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0388791
Code Inist : 002B30A04B. Création : 25/01/1999.