Despite only modest associations with mortality, we observed a steady increase in healthcare costs when delaying surgery. Hence, a more pragmatic approach with surgery as soon as medically and organizationally possible seems justifiable over rigorous implementation of the current guidelines.
Cost-utility analysis of surgery and radiotherapy for symptomatic spinal utility analysis of surgery and radiotherapy for symptomatic spinal utility analysis of surgery and radiotherapy for symptomatic spinal utility analysis of surgery and radiotherapy for symptomatic spinal metastases in a Belgian specialist center. metastases in a Belgian specialist center. metastases in a Belgian specialist center. metastases in a Belgian specialist center.
Belgian legislation limiting the number of embryos for transfer has been shown to result in a 50% reduction of the multiple live birth rate (MLBR) per cycle without having a negative impact on the cumulative delivery rate per patient within six cycles or 36 months. The objective of the current study was to evaluate the cost saving associated with a 50% reduction in MLBR. A retrospective cost analysis was performed of 213 couples, who became pregnant and had a live birth after one or more assisted reproductive technology treatment cycles, and their 254 children. The mean cost of a singleton (n = 172) and multiple (n = 41) birth was calculated based on individual hospital invoices. The cost analysis showed a significantly higher total cost (assisted reproductive technology treatment, pregnancy follow-up, delivery, child cost until the age of 2 years) for multiple births (both children: mean €43,397) than for singleton births (mean: €17,866) (Wilcoxon-Mann-Whitney P < 0.0001). A 50% reduction in MLBR resulted in a significant cost reduction related to hospital care of 13%.
We describe the incidence of tibial plateau fractures and the evolution of its management and financial burden in Belgium, perform a similar audit at University Hospitals Leuven, and define strategies to curb the increasing cost. Methods National data on tibial plateau fractures was collected from the NIHDI and compared to our performance. Several clinical parameters such as age, sex, treatment modality and length-of-stay were included. The total healthcare costs are considered as the sum of hospitalization costs and ambulatory care costs.
ResultsBetween 2006 and 2018, a total number of 35,226 tibial plateau fractures were diagnosed in Belgium and 861 in our center. The incidence increased 41% over time (mean 25/100,000 persons per year). The mean rate of surgery in Belgium was 37% and slightly decreased over time, due to a larger increase of nonoperatively treated tibial plateau fractures. The rate of surgery at the UHL was 49%. Surprisingly, the average cost per patient was equal for operatively and non-operatively treated patients in Belgium, and driven by the length-of stay.
ConclusionSince length-of-stay is the main driver of the total healthcare costs of tibial plateau fractures, guidelines on appropriate length-of-stay can help to decrease variability and curb the total healthcare costs, particularly of the non-operatively treated patients. Our performance was in line with this.
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