Background A policy of withholding endoscopy in Helicobacter pylori sero-negative dyspeptic patients without sinister symptoms saves up to 36% of endoscopies.
However, it is unclear whether the net cost of applying this policy outweighs that of conventional management Aim To determine the direct (healthcare) and indirect (productivity) costs of applying a strategy of endoscopy versus no endoscopy in H. pylor sero-negative young dyspeptics in the UK.
Method The direct and indirect incremental costs for both strategies were calculated amongst 154 H. pylori sero-negative subjects randomized to have an endoscopy or no endoscopy before subsequent management by their general practitioners.
The cost per patient of each strategy was calculated using reference values in our clinical setting and sensitivity analysis was used to test different scenarios.
Results The total direct cost rose for the endoscopy group (mean £103,95% Cl 78 to 127) but did not change for the non-endoscopy group (mean £6,95% Cl - 32 to 44).
On average, direct (healthcare) costs for patients in the endoscopy group rose by £96 (95% Cl 51 to 142) more than those for non-endoscopy patients.
Indirect (productivity) cost fell for the non-endoscopy group (mean - £40,95% Cl - 220 to 140) compared to a rise for the endoscopy group (mean £180,95% Cl - 60 to 420) (difference not significant). (...)
Mots-clés Pascal : Dyspepsie, Séronégativité, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Indication, Gastroscopie, Analyse avantage coût, Randomisation, Adulte jeune, Homme, Appareil digestif pathologie, Endoscopie
Mots-clés Pascal anglais : Dyspepsia, Seronegativity, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Indication, Gastroscopy, Cost benefit analysis, Randomization, Young adult, Human, Digestive diseases, Endoscopy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0450812
Code Inist : 002B24E06. Création : 22/03/2000.