Centre for Reproductive Biology, The University of Edinburgh, Edinburgh EH16 4TJ, UK.
Hum Reprod. 2010 Feb;25(2):328-33. doi: 10.1093/humrep/dep397. Epub 2009 Nov 20.
The diagnosis of ectopic pregnancy in women presenting in early pregnancy is often protracted, relying on costly investigations that are psychologically burdensome to the patient. The aim of this study was to evaluate the financial costs to the health services in Scotland of the current methods used to diagnose and exclude ectopic pregnancy, and compare these with that of a theoretical single diagnostic serum biomarker.
We conducted a retrospective cost-description analysis (with and without costs of diagnostic laparoscopy) of the health-care costs incurred by all patients presenting to a large Scottish teaching hospital between June and September 2006 with pain and bleeding in early pregnancy, where ectopic pregnancy was not excluded. Additionally, a cost minimization analysis was performed for the costs of current ectopic pregnancy investigations versus those of a theoretical single diagnostic serum biomarker. This included sensitivity analyses where the biomarker was priced at increasing values and assumed to have less than 100% diagnostic sensitivity and specificity.
About 175 patients were eligible to be included in the analysis. Forty-seven per cent of patients required more than three visits to diagnose or exclude ectopic pregnancy. The total yearly cost for diagnosing and excluding ectopic pregnancy was 197K pound sterling for the hospital stated, and was estimated to be 1364K pound sterling for Scotland overall. Using a theoretical diagnostic serum biomarker we calculated that we could save health services up to 976K pound sterling (lowest saving 251K pound sterling after subanalysis) every year in Scotland.
Ectopic pregnancy is expensive to diagnose and exclude, and the investigation process is often long and might involve significant psychological morbidity. The development of a single diagnostic serum biomarker would minimize this morbidity and lead to significant savings of up to 1 million pounds per year in Scotland.
在孕早期，异位妊娠的诊断通常很耗时，需要进行昂贵的检查，这给患者带来了心理负担。本研究旨在评估苏格兰目前用于诊断和排除异位妊娠的方法的卫生服务费用，并将其与理论上的单一诊断血清生物标志物进行比较。
我们对 2006 年 6 月至 9 月期间在苏格兰一所大型教学医院就诊的因早期妊娠疼痛和出血而未排除异位妊娠的所有患者的医疗费用进行了回顾性成本描述分析（包括和不包括诊断性腹腔镜检查的成本）。此外，还对当前异位妊娠检查的成本与理论上的单一诊断血清生物标志物的成本进行了成本最小化分析。这包括对生物标志物进行敏感性分析，假设生物标志物的价格不断上涨，且诊断敏感性和特异性均低于 100%。
约有 175 名患者符合纳入分析的条件。47%的患者需要进行三次以上的就诊才能诊断或排除异位妊娠。医院诊断和排除异位妊娠的年总成本为 197 万英镑，苏格兰的总成本估计为 1364 万英镑。使用理论上的诊断血清生物标志物，我们计算出，我们每年可以为苏格兰的卫生服务节省高达 976 万英镑（经过子分析后，最低节省额为 251 万英镑）。
异位妊娠的诊断和排除费用昂贵，且检查过程往往很长，可能会给患者带来很大的心理负担。开发单一的诊断血清生物标志物将最大限度地减少这种发病率，并导致苏格兰每年节省高达 100 万英镑的费用。
