Economic burden and cost determinants of deep vein thrombosis during two years following diagnosis: a prospective evaluation.
J Thromb Haemost. 2011 Sep 22;
Authors: Guanella R, Ducruet T, Johri M, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Ginsberg JS, Lamping DL, Shrier I, Kahn SR
Abstract
Background: Few studies have evaluated the long-term economic consequences of deep venous thrombosis (DVT). None of them incorporated prospectively collected clinical data to ensure accurate identification of incident cases of DVT and DVT-related health outcomes of interest such as post-thrombotic syndrome (PTS). Objectives: To prospectively quantify medical and non-medical resource use and costs related to DVT during two years following diagnosis, and to identify clinical determinants of costs. Methods: 355 consecutive patients with acute DVT were recruited at 7 Canadian hospital centers. Resource use and cost information were retrieved from 3 sources: weekly patient-completed cost diaries, nurse-completed case report forms and the Quebec provincial administrative healthcare database ("RAMQ"). Results: The rate of DVT-related hospitalization was 3.5 per 100 patient-years (95% CI 2.2, 4.9). Patients reported a mean (SD) of 15.0 (14.5) physician visits and 0.7 (1.2) other healthcare professionals visits. The average cost of DVT was $5180 (95% CI $4344, $6017) in Canadian dollars with 51.6% of costs attributable to non-medical resource use. Multivariate analysis identified 4 independent predictors of costs: concomitant pulmonary embolism (relative increase in cost [RIC]: 3.16; 95% CI 2.18, 4.58), unprovoked DVT (RIC: 1.65; 95% CI 1.28, 2.13), development of PTS during follow-up (RIC: 1.35; 95% CI 1.05, 1.74), and management of DVT in the inpatient setting (RIC: 1.79; 95% CI 1.33, 2.40). Conclusions: Economic burden of DVT is substantial. Use of measures to prevent occurrence of PTS and favoring outpatient care of DVT has the potential to diminish costs.
PMID: 21951970 [PubMed - as supplied by publisher]