BackgroundHip fractures require operation within 36–48 h, and they are most common in the elderly. A high International Normalized Ratio should be corrected before surgery. In the current study, we analyzed the budget impact of various warfarin reversal approaches.MethodsFour reversal strategies were chosen for the budget impact analysis: the temporary withholding of warfarin, administration of vitamin K, fresh frozen plasma (FFP), and a four-factor prothrombin complex concentrate (PCC).ResultsWe estimated that, annually, 410 hip fracture patients potentially require warfarin reversal in Finland. The least costly treatment was vitamin K, which accounted for €289,000 in direct healthcare costs, and the most costly treatment option was warfarin cessation, which accounted for €1,157,000. In the budget impact analysis, vitamin K, PCC and FFP would be cost-saving to healthcare compared with the current treatment mix.ConclusionThe various warfarin reversal strategies have different onset times, which may substantially impact the subsequent healthcare costs.
tion was built (Tableau 8) to visualize the information to be easily communicated to local authorities and clinicians. Results: A middle-sized Finnish municipality with 74 168 inhabitants (Joensuu) was chosen as a case-example. The estimated number of diabetic patients was 2267, out of which 1678 had T2D. Within three years among patients with T2D, the predicted number of CHD events would be 73 and 57 for HbA1c levels 6.5% and 8.0%, respectively, resulting total of 16 avoidable CHD events. ConClusions: By bringing the understanding of epidemiology and treatment effects to local level, there is a possibility to show the positive outcomes of good diabetes care in real practice. This information may be used to help budget holders in resource allocation and to motivate authorities, clinicians (and patients) to follow the diabetes treatments guidelines.
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