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Endoscopic therapy of bleeding peptic ulcers: a cost-benefit analysis.
Nishioka, N S; Richter, J M.
Afiliación
  • Nishioka NS; Medical Service, (Gastrointestinal and General Internal Medicine Units), Massachusetts General Hospital, Boston 02114.
Gastrointest Endosc ; 33(4): 277-83, 1987 Aug.
Article en En | MEDLINE | ID: mdl-3115860
Endoscopic hemostatic therapies have become increasingly popular and appear capable of controlling hemorrhage from peptic ulcers and reducing the need for surgery, but many physicians are unsure that the efficacy justifies the cost. In order to study this clinically and economically important issue, we developed a mathematical model to analyze the economics of endoscopic therapy of bleeding peptic ulcers. Endoscopic therapy appears capable of reducing direct hospital costs only when selectively applied to those patients with the highest risk of requiring surgery. Sensitivity analysis identifies efficacy, treatment cost, and the rebleeding rate in untreated patients as the most critical variables affecting the cost of interventional endoscopy. Using neodymium: YAG laser photocoagulation as an example, interventional endoscopy can be cost-effective for treating selected patients with bleeding peptic ulcers. Should other hemostatic devices such as the heater probe and bipolar electrocoagulator prove to be as effective as the laser, even greater cost savings could be achieved.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Úlcera Péptica Hemorrágica / Endoscopía / Fotocoagulación Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Humans Idioma: En Revista: Gastrointest Endosc Año: 1987 Tipo del documento: Article Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Úlcera Péptica Hemorrágica / Endoscopía / Fotocoagulación Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Humans Idioma: En Revista: Gastrointest Endosc Año: 1987 Tipo del documento: Article Pais de publicación: Estados Unidos