Direct costs for treatment of venous thromboembolism complication 90-day after surgery
VNU Journal of Science: Medical and Pharmaceutical Sciences(2019)
Abstract
Study object: Describe the direct treatment costs due to venous thromboembolism complications 90 days after surgery by using national health insurance reimbursement database. Patients: 824,947 adult patients who underwent major surgeries were enrolled from January 1, 2017 to September 31, 2018. Method: Study was conducted by using cross-sectional descriptive design. Patients were considered VTE case if they had a diagnostic code up to 90 days after the first surgery, thus 1472 were diagnosed as having VTE after surgery. The study using propensity score matching method shows that there were 913 pairs of patients with the same propensity score included in analysis. Results: The rate of hospital re-admission and outpatient visit were 41.7% and 60.8% in group of VTE patient after matching, respectively. The mean 90-day postoperative cost in VTE group after matching was found to be 89.652 ± 107.928 thousand VNĐ, which is 1.5 times higher than the expenditure of non-VTE group with 61.474± 81.115 thousand VNĐ. Conclusion: The costs related to VTE treatment can be used to evaluate the potential economic benefit and cost-savings from efforts of VTE prevention. Keywords Venous thromboembolism, direct treatment costs. References [1] W.H. Geerts, G.F. Pineo, J.A. Heit, et al, Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy, Chest 126 (2004) 338-400. https:// doi.org/10.1378/chest.126.3_suppl.338S.[2] V.V. Tam, N.V. Thong, The rate of deep venous thrombosis related to hip and knee arthroplasty – A study in Cho Ray Hospital (in Vietnamese), Ho Chi Minh City Medical Journal 18(2) (2014) 250-256.[3] A.C. Spyropoulos, J.S. Hurley, G.N. Ciesla, et al, Management of acute proximal deep vein thrombosis: pharmacoeconomic evaluation of outpatient treatment with enoxaparin vs inpatient treatment with unfractionated heparin, Chest 122 (2002) 108-14. https://doi.org/10.1378/chest.122.1.108.[4] D.A. Ollendorf, M. Vera-Llonch ,G. Oster., Cost of venous thromboembolism following major orthopedic surgery in hospitalized patients, Am J Health Syst Pharm 59(18) (2002) 1750-4. https://doi.org/10.1093/ajhp/59.18.1750[5] J.Y.S. Ng, R.V. Ramadani, D. Hendrawan, et al,National Health Insurance Databases in Indonesia, Vietnam and the Philippines, Pharmacoecon Open (2019). https://doi.org/ 10.1007/s41669 -019-0127-2.[6] H. Assareh, J. Chen, L. Ou, et al, Rate of venous thromboembolism among surgical patients in Australian hospitals: a multicentre retrospective cohort study, BMJ Open 4(10) (2014) 5502. https://doi.org/10.1136/bmjopen-2014-005502.[7] Agency for Healthcare Research and Quality (AHRQ), Patient safety indicator v4.5 benchmark data tables, (2013).[8] I.A. Naess, S.C. Christiansen, P. Romundstad, et al.,Incidence and mortality of venous thrombosis: a population-based study, J Thromb Haemost 5(4) (2007) 692-9. https://doi.org/10.1111/j.1538-7836.2007.02450.x.[9] D.C. Sutzko, P.E. Georgoff, A.T. Obi, et al, The Association Of Venous Thromboembolism Chemoprophylaxis Timing on Venous Thromboembolism After Major Vascular Surgery, J Vasc Surg 67(1) (2018) 262-271. https://doi.org/ 10.1016/j.jvs.2017.06.087.[10] F.A. Anderson, F.A. Spencer, Risk factors for venous thromboembolism, Circulation 107(23) (2003) 9-16. https://doi.org/ 10.1161/01.CIR.0000078 469.07362.E6[11] J. Lin, A.C. Spyropoulos, Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative claims analysis from 30 managed care organizations, J Manag Care Pharm 13(6) (2007) 475-86. https://doi.org/10.18553/jmcp.2007.13.6.475[12] D.J. Tillman, S.L. Charland, D.M. Witt, Effectiveness and economic impact associated with a program for outpatient management of acute deep vein thrombosis in a group model health maintenance organization, Arch Intern Med, 160(19) (2000) 2926-32. https://doi.org/ 10.1001/archinte.160.19.2926.[13] M. Sakon, Y. Maehara, T. Kobayashi, et al, Economic Burden of Venous Thromboembolism in Patients Undergoing Major Abdominal Surgery, Value in Health Regional Issue 6 (2015) 73-79. https://doi.org/10.1016/j.vhri. 2015. 03.017.[14] A. Sepasso, F. Chingcuanco, E. Gordon, et al, Resource utilization and charges of patients with and without diagnosed venous thromboembolism during primary hospitalization and after elective inpatient surgery: a retrospective study, Journal of Medical Economics 21(6) (2018) 595-602. https://doi.org/10.1080/13696998.2018.1445635.[15] Shinro Takai, Masao Akagi, Bruce Crawford, et al, Economic Impact of Venous Thromboembolism Following Major Orthopaedic Surgery in Japan, Value in Health Regional Issues 2(1) (2013) 81-86. https://doi.org/ 10.1016/j.vhri.2013.01.001.
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Key words
venous thromboembolism complication,surgery,direct costs
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