Home Treatment Compared to Initial Hospitalization in Normotensive Patients with Acute Pulmonary Embolism in the Netherlands: A Cost Analysis.
Cost Savings
/ methods
Duration of Therapy
Female
Health Care Costs
/ classification
Hemodynamics
Home Care Services
/ economics
Hospitalization
/ economics
Humans
Male
Middle Aged
Netherlands
/ epidemiology
Patient Acceptance of Health Care
/ statistics & numerical data
Pulmonary Embolism
/ epidemiology
Triage
/ methods
Venous Thromboembolism
/ complications
Journal
Thrombosis and haemostasis
ISSN: 2567-689X
Titre abrégé: Thromb Haemost
Pays: Germany
ID NLM: 7608063
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
aheadofprint:
26
05
2021
pubmed:
28
5
2021
medline:
23
3
2022
entrez:
27
5
2021
Statut:
ppublish
Résumé
Venous thromboembolism constitutes substantial health care costs amounting to approximately 60 million euros per year in the Netherlands. Compared with initial hospitalization, home treatment of pulmonary embolism (PE) is associated with a cost reduction. An accurate estimation of cost savings per patient treated at home is currently lacking. The aim of this study was to compare health care utilization and costs during the first 3 months after a PE diagnosis in patients who are treated at home versus those who are initially hospitalized. Patient-level data of the YEARS cohort study, including 383 normotensive patients diagnosed with PE, were used to estimate the proportion of patients treated at home, mean hospitalization duration in those who were hospitalized, and rates of PE-related readmissions and complications. To correct for baseline differences within the two groups, regression analyses was performed. The primary outcome was the average total health care costs during a 3-month follow-up period for patients initially treated at home or in hospital. Mean hospitalization duration for the initial treatment was 0.69 days for those treated initially at home ( Home treatment of hemodynamically stable patients with acute PE was associated with an estimated net cost reduction of €1,483 per patient. This difference underlines the advantage of triage-based home treatment of these patients.
Sections du résumé
BACKGROUND
Venous thromboembolism constitutes substantial health care costs amounting to approximately 60 million euros per year in the Netherlands. Compared with initial hospitalization, home treatment of pulmonary embolism (PE) is associated with a cost reduction. An accurate estimation of cost savings per patient treated at home is currently lacking.
AIM
The aim of this study was to compare health care utilization and costs during the first 3 months after a PE diagnosis in patients who are treated at home versus those who are initially hospitalized.
METHODS
Patient-level data of the YEARS cohort study, including 383 normotensive patients diagnosed with PE, were used to estimate the proportion of patients treated at home, mean hospitalization duration in those who were hospitalized, and rates of PE-related readmissions and complications. To correct for baseline differences within the two groups, regression analyses was performed. The primary outcome was the average total health care costs during a 3-month follow-up period for patients initially treated at home or in hospital.
RESULTS
Mean hospitalization duration for the initial treatment was 0.69 days for those treated initially at home (
CONCLUSION
Home treatment of hemodynamically stable patients with acute PE was associated with an estimated net cost reduction of €1,483 per patient. This difference underlines the advantage of triage-based home treatment of these patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
427-433Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
F.K. reports research grants from Bayer, Bristol-Myers Squibb, Boehringer-Ingelheim, Daiichi-Sankyo, MSD, Actelion, the Dutch Heart Foundation, and the Netherlands Thrombosis Foundation, outside the submitted work. M.H. reports grants from ZonMW Dutch Healthcare Fund, grants and personal fees from Boehringer Ingelheim, grants and personal fees from Pfizer-BMS, grants and personal fees from Bayer Health Care, grants from Aspen, and grants and personal fees from Daiichi-Sankyo, outside the submitted work.