Seymour Janelle, Wallage Sarah, Graham Wendy, Parkin David, Cooper Kevin
Health Economics Research Unit, University of Aberdeen, Medical School Foresterhill, Scotland, UK.
BJOG. 2003 Oct;110(10):922-6.
To compare the costs of microwave endometrial ablation under local anaesthetic and general anaesthetic in an operating theatre and to estimate the cost of performing treatment under local anaesthetic in a dedicated clinic setting.
The costing study was undertaken alongside a randomised controlled trial comparing the acceptability of microwave endometrial ablation using local versus general anaesthetic in a theatre setting.
Department of Gynaecology, Aberdeen Royal Infirmary, Scotland.
One hundred and twenty-seven women undergoing microwave endometrial ablation who had been randomly allocated to general or local anaesthetic.
Health and non-health service resource use was recorded prospectively. Data on resource use were combined with unit costs estimated using standardised methods to determine the cost per patient for microwave endometrial ablation under local or general anaesthetic in theatre. A model was developed to estimate the health service cost of microwave endometrial ablation under local anaesthetic in a clinic setting.
Health and non-health service costs.
There was little difference in cost when treatments were performed under local or general anaesthetic in theatre. The median health and non-health cost of microwave endometrial ablation was 440 pounds and 120 pounds, respectively, under general anaesthetic and 428 pounds and 125 pounds per women under local anaesthetic. The health service cost of microwave endometrial ablation using local anaesthetic in a clinic setting was estimated to be 432 pounds per treatment; however, this varied from 389 pounds to 491 pounds in the sensitivity analysis.
There are minimal cost savings to the patient or health service from using local rather than general anaesthetic for microwave endometrial ablation in a theatre setting. Cost modelling suggests that in a clinic setting microwave endometrial ablation has a similar cost to theatre based treatment once re-admissions for treatment under general anaesthetic are considered. Sensitivity analysis indicated that these findings were sensitive to assumptions in the model.
比较在手术室中局部麻醉和全身麻醉下进行微波子宫内膜消融术的成本，并估算在专门诊所环境中局部麻醉下进行治疗的成本。
成本核算研究与一项随机对照试验同时进行，该试验比较了在手术室环境中使用局部麻醉与全身麻醉进行微波子宫内膜消融术的可接受性。
苏格兰阿伯丁皇家医院妇科。
127名接受微波子宫内膜消融术的女性，她们被随机分配接受全身麻醉或局部麻醉。
前瞻性记录卫生和非卫生服务资源的使用情况。将资源使用数据与使用标准化方法估算的单位成本相结合，以确定在手术室中局部麻醉或全身麻醉下进行微波子宫内膜消融术的每位患者的成本。开发了一个模型来估算在诊所环境中局部麻醉下进行微波子宫内膜消融术的卫生服务成本。
卫生和非卫生服务成本。
在手术室中进行局部麻醉或全身麻醉治疗时，成本差异不大。全身麻醉下微波子宫内膜消融术的卫生和非卫生成本中位数分别为440英镑和120英镑，局部麻醉下每位女性分别为428英镑和125英镑。在诊所环境中使用局部麻醉进行微波子宫内膜消融术的卫生服务成本估计为每次治疗432英镑；然而，在敏感性分析中，这一成本在389英镑至491英镑之间波动。
在手术室环境中，对于微波子宫内膜消融术，使用局部麻醉而非全身麻醉，患者或卫生服务节省的成本微乎其微。成本模型表明，在诊所环境中，一旦考虑到因全身麻醉下再次入院治疗的情况，微波子宫内膜消融术的成本与基于手术室的治疗相似。敏感性分析表明，这些发现对模型中的假设敏感。
