Background Patients with recurrent syncope frequently undergo extensive investigations that consume significant health care resources.
Recent advances in long-term monitoring techniques have enhanced diagnostic yield in patients with infrequent symptoms.
There is little information on the relative cost-effective profile of the investigative tools used in patients with syncope.
Methods Two methods to determine health care costs in patients with syncope were used.
In the first, health care resource utilization was determined in 24 patients with recurrent unexplained syncope and negative investigations who underwent insertion of the implantable loop recorder (ILR) during a pilot study of the feasibility of the device.
The costs of investigations before, during, and after ILR implantation in each patient were calculated on the basis of median charges for an index investigation and a regression analysis of 1018 US Medicare hospital claims for syncope from 1993.
Charges were converted to costs using a cost-to-charge ratio of 0.64.
The second method was based on estimated costs per diagnosis and published diagnostic yields of 6 commonly applied tests in patients with syncope.
A cohort simulation using theoretic models of 100 patients undergoing investigation for syncope was created to compare the diagnostic yield and cost per diagnosis of various diagnostic cascades. (...)
Mots-clés Pascal : Syncope, Récidive, Enregistreur, Implanté, Analyse coût efficacité, Economie santé, Diagnostic, Technique, Homme, Système nerveux pathologie, Trouble neurologique, Trouble conscience
Mots-clés Pascal anglais : Syncope, Relapse, Recorder, Implanted, Cost efficiency analysis, Health economy, Diagnosis, Technique, Human, Nervous system diseases, Neurological disorder, Consciousness impairment
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0330708
Code Inist : 002B17A03. Création : 16/11/1999.