Key result
An outpatient treatment strategy for acute deep venous thrombosis significantly reduced total direct costs compared to an inpatient strategy (SEK 12100 vs SEK 16400 per patient; p < 0.001).
Why the study?
Does an outpatient treatment strategy reduce direct costs compared to an inpatient strategy in patients with acute deep venous thrombosis?
RCT (n=131)
randomised
Yes
Does an outpatient treatment strategy reduce direct costs compared to an inpatient strategy in patients with acute deep venous thrombosis?
Absolute Event Rate: 12100% vs 16400%
p-value: p=< 0.001
Outpatient treatment of acute deep venous thrombosis with dalteparin is safe and significantly reduces direct costs compared to inpatient treatment.
Supports outpatient DVT management to cut direct costs; confirms economic benefit of this strategy in randomized evidence.
OBJECTIVE: A health economic evaluation of two alternative treatment settings, inpatient care and outpatient care, for acute deep venous thrombosis. DESIGN: A randomised multicentre trial in a defined population in regular clinical practice. SETTING: Hospitals and related health care centres in the Jönköping county council in Sweden. INTERVENTIONS: Patients were randomised to either an inpatient strategy (n = 66) or an outpatient strategy (n = 65) using low-molecular-weight heparin, dalteparin, administered subcutaneously once daily and adjusted for body weight. SUBJECTS: Of 224 eligible patients, 131 entered the trial and 124 completed the economic part of the study. MAIN OUTCOME MEASURES: Direct medical and direct non-medical costs during a 3-month period. RESULTS: Total direct costs were higher for those in the inpatient strategy group, i.e. Swedish Crowns (SEK) 16400 per patient (Euro 1899) compared to SEK 12100 per patient (Euro 1405) in the outpatient strategy group (p < 0.001). More patients in the outpatient group received assistance when they returned home. Few patients in either group reported sick leave. There was no difference in total number of days between the two groups. CONCLUSIONS: Total direct costs were significantly lower for the outpatient treatment strategy for deep venous thrombosis compared to the inpatient treatment strategy. No significant difference in health impact could be detected. Deep venous thrombosis can to a greater extent than previously be treated in primary care, safely, at a lower cost, and in accordance with patient preferences.
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Bäckman et al. (2004) conducted an RCT in acute deep venous thrombosis (n=131). Outpatient strategy using dalteparin vs. Inpatient strategy was evaluated on Total direct medical and direct non-medical costs during a 3-month period (p=< 0.001). An outpatient treatment strategy for acute deep venous thrombosis significantly reduced total direct costs compared to an inpatient strategy (SEK 12100 vs SEK 16400 per patient; p < 0.001).
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