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Table 3 Summary of sensitivity analyses: mean total costs and estimated absolute and relative differences between relaparotomy on demand and planned relaparotomy across alternative assumptions and calculation methods

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

    Mean Mean   %
  Description OD PR difference 95% CIa Difference
Analysis       
Main Main analysis (most probable assumptions) 65,768 83,450 17,682 (5,062 to 29,004) 21.2%
1 Percutaneous drainage procedures (reimbursement fee as opposed to AMC estimate) 65,754 83,428 17,674 (5,057 to 28,975) 21.2%
2 Ward-stay unit costs (weighted average of Academic and General hospitals)b 62,938 81,016 18,078 (5,437 to 28,640) 22.3%
3 ICU-day unit costs (AMC top-down calculation instead of guideline) 70,694 90,980 20,286 (5,959 to 32,160) 22.3%
4 With ICU-day unit costs estimated for      
  A United Kingdom 63,235 79,688 16,453 (4,788 to 28,439) 20.6%
  B Germany 61,541 77,172 15,631 (4,578 to 28,037) 20.3%
  C France 69,102 88,401 19,299 (5,371 to 29,721) 21.8%
  D Norway 77,225 100,465 23,240 (5,948 to 31,306) 23.1%
  E Austria 63,794 80,518 16,724 (4,851 to 28,560) 20.8%
  F Canada 58,960 73,338 14,378 (4,223 to 27,415) 19.6%
5 Exclude all costs of relaparatomy procedures 62,543 77,913 15,370 (3,018 to 25,395) 19.7%
  1. aBased on geometric means; bweighted by ratio of Academic and General hospital beds in the Netherlands (1:6). Explanation of different sensitivity analyses: (1) for percutaneous drainage procedure, AMC-unit costs estimates were replaced by reimbursement fees for this procedure. (2) To avoid the encountered cost differences where direct results from the differentiation between academic and nonacademic hospitals, a weighted average unit cost per hospital ward day was used. This average was weighted by the actual ratio of academic and nonacademic hospital beds in the Netherlands [29]. (3) We differentiated between unit costs of relaparotomies with and those without other surgical procedures (such as enterostomy (re)construction, abscess drainage, colon resection) instead of using the same all-in unit costs for all relaparotomies. (4a through f) To enhance generalizability of the results to other countries with publicly financed health care systems, Dutch reference prices for ICU days were replaced by unit costs estimated for the UK, Germany, France, Norway, Austria, and Canada, respectively [10, 1923]. Additionally (5), we compared the total costs of the two strategies when disregarding the costs of relaparotomy procedures during the index admission because these differences were intrinsic to the strategy itself, as the planned strategy involved more procedures than did the on-demand strategy.