Costs of relaparotomy on-demand versus planned relaparotomy in patients with severe peritonitis: an economic evaluation within a randomized controlled trial

Opmeer, Brent C; Boer, Kimberly R; van Ruler, Oddeke; Reitsma, Johannes B; Gooszen, Hein G; de Graaf, Peter W; Lamme, Bas; Gerhards, Michael F; Steller, E Philip; Mahler, Cecilia M; Obertop, Huug; Gouma, Dirk J; Bossuyt, Patrick MM; de Borgie, Corianne AJM; Boermeester, Marja A

doi:10.1186/cc9032

Critical Care

Table 2 Mean use of resources and costs in the on-demand and planned-relaparotomy groups during index admission and follow-up until 1 year after randomization

From: Costs of relaparotomy on-demand versus planned relaparotomy in patients with severe peritonitis: an economic evaluation within a randomized controlled trial

		OD (n = 114)		PR (n = 115)		Difference (PR-OD)
	Unit	Mean volume	Mean costs p.p. (€)	Mean volume	Mean costs p.p.(€)	Mean costs p.p. (€)
Direct medical costs
Index admission
Admission
Ward stay, index (excl ICU)	Day	26	11,609	27	11,784	175
ICU stay	Day	12	21,040	18	31,248	10,208
Interventions
(re)Laparotomy
Index laparotomy	Procedure	1.0	2,267	1.0	2,267	0
Second-look	Procedure	0.62	1,139	1.5	2,831	1,692
with other surgical procedures	Procedure	0.37	1,211	0.47	1,543	332
Percutaneous drainage	Procedure	0.41	123	0.67	199	84
Diagnostic CT and cultures
CT	Procedure	1.2	302	1.4	341	39
Microbiology	Cultures	43	586	58	792	206
Medication and other materials
Antibiotic therapy (excl ICU)	Day	6.0	474	6.1	619	145
Enterostomy care^b	Day	24	741	29	917	176
Blood products	Unit	0.61	89	1.04	178	89
Mechanical ventilation	Day	8.3	3,080	12	4,360	1,280
SUBTOTAL			42,661		57,079	14,418
Follow-up
		OD (n = 112)		PR (n = 113)
Inpatient care
Ward stay, follow up	Day	9.5	4,280	11.8	5,083	803
Elective surgery	Procedure	0.39	875	0.51	1,163	288
Percutaneous drainage	Procedure	0.08	24	0.11	32	84
Outpatient care
Specialist consultation^a	Visit	16.3	1,297	16.7	1,333	36
CT abdomen	Procedure	0.07	18	0.03	7	-11
US abdomen	Procedure	0.05	5	0.03	2	-2
Plain radiograph	Procedure	0.18	8	0.12	5	-3
Enterostomy care^b	Day	140	4,449	150	4,767	318
Other health care providers
Primary care physician^a	Visit	9.4	194	8.5	175	-19
Company doctor^a	Visit	1.8	42	1.4	31	-10
Paramedical specialist^a	Visit	29	675	29	667	-7
District nurse^a	Hour	45	1,836	71	2,947	1,111
Rehabilitation center^a	Day	19	6,480	23	8,040	1,560
SUBTOTAL			20,183		24,252	4,069
Direct nonmedical costs
Travel costs^a	Km	395	71	393	71	0
Indirect costs
Absence from paid work^a	Day	70	2,854	50	2,048	-806
Total costs (€)			65,768		83,450	17,682

^aPR n = 74/OD n = 76: number of patients on whom analyses are based. Average costs per patients per day outside the hospital within each arm were extrapolated to patients for whom this information was not available. ^bPR n = 53 patients with enterostomy; OD n = 49 patients with enterostomy; volume, average amount of resources used per patient; total costs, total costs of resource use of all patients; mean costs, average cost per patient; difference, difference between PR and OD (positive values in favor of OD).

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ISSN: 1364-8535

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