Direct costs for treatment of venous thromboembolism complication 90-day after surgery

Bui My Hanh, Duong Duc Tuan, Tran Tien Hung, Nguyen Huu Chinh, Kieu Thi Tuyet Mai
2019 VNU Journal of Science Medical and Pharmaceutical Sciences  
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
more » ... 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.
doi:10.25073/2588-1132/vnumps.4178 fatcat:jof6shheerebxo62friqnvvtpi