Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives

Loras, Carme; Mayor, Vicenç; Fernández‐Bañares, Fernando

doi:10.1016/j.dld.2018.03.002

Cited by 17 publications

(10 citation statements)

References 21 publications

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“…This method is analogous to the bottom-up approach (micro-costing), but has several advantages like allowing for the generalization of results obtained in different settings with variable levels of complexity because it does not consider structural or indirect costs. 19 , 20…”

Section: Methodsmentioning

confidence: 99%

Centers of Excellence Implementation for Treating Rheumatoid Arthritis in Colombia: A Cost-Analysis

Santos-Moreno¹,

Alvis-Zakzuk

Villarreal-Peralta³

et al. 2021

CEOR

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Background Health systems need to optimize the use of resources, especially in high-cost diseases as rheumatoid arthritis (RA). We aimed to evaluate the efficiency of using centers of excellence (CoE) as a strategy for improving RA treatment in Colombia. Methods A cost description analysis was carried out using the standard costing technique. We estimated the costs of medical consultations, laboratories, images, and medications for RA. Categories of care standards stratified by severity were defined using the disease activity score in 28 joints (DAS28). We evaluated the impact, in terms of costs (US dollars), for providing RA clinical care for a previously described cohort using the CoE approach. Statistical analyses were performed in Microsoft Excel ® , and R. Results Expenditure on therapeutic drugs increases as the severity of RA increases. Drugs represent 53.6% of the total cost for the low disease activity (LDA) stage, 75.2% for moderate disease activity (MDA), 88.5% for severe disease activity (SDA) and 97% for SDA with biologic treatment (SDA+Biologic). Treating 968 patients would cost US$612,639 (US$487,978–1,220,160) at baseline, per year. After a year of follow-up at the CoE, treating the same patients would cost US$388,765 (US$321,710–708,476), which implies potential cost-savings of up to US$223,874 per year. Conclusion The strategy of providing clinical care for RA through CoE can save US$231.3 per patient-per year. The results of our study show that CoE could greatly impact the public policies dealing with treatment of RA in Colombia. Applying the CoE model in our country would both improve health outcomes, as well as being more efficient in terms of costs.

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Section: Methodsmentioning

confidence: 99%

Centers of Excellence Implementation for Treating Rheumatoid Arthritis in Colombia: A Cost-Analysis

Santos-Moreno¹,

Alvis-Zakzuk

Villarreal-Peralta³

et al. 2021

CEOR

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“…High capital costs for the initial purchase of processors, scopes, and repair costs are cited as factors against choledochoscopy. For recurring costs for performing a single procedure, Loras et al [ 130 ] found that additional choledochoscopy use during ERCP in 2018 can increase procedural costs alone by $3662.71 and $2637.02 for stone extraction and stricture diagnosis, respectively. ERCP with choledochoscopy was the most expensive among advanced endoscopic procedures studied, even though ERCP alone was not more expensive than most other procedures[ 130 ].…”

Section: Limitationsmentioning

confidence: 99%

Choledochoscopy: An update

Lee¹,

Teng²,

Shelat³

2021

WJGE

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Choledochoscopy, or cholangioscopy, is an endoscopic procedure for direct visualization within the biliary tract for diagnostic or therapeutic purposes. Since its conception in 1879, many variations and improvements are made to ensure relevance in diagnosing and managing a range of intrahepatic and extrahepatic biliary pathologies. This ranges from improved visual impression and optical guided biopsies of indeterminate biliary strictures and clinically indistinguishable pathologies to therapeutic uses in stone fragmentation and other ablative therapies. Furthermore, with the evolving understanding of biliary disorders, there are significant innovative ideas and techniques to fill this void, such as nuanced instances of biliary stenting and retrieving migrated ductal stents. With this in mind, we present a review of the current advancements in choledo-choscopy with new supporting evidence that further delineates the role of choledochoscopy in various diagnostic and therapeutic interventions, complications, limitations and put forth areas for further study.

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“…The mean rate of CSPEB incidence after EMR of LNPCLs is 6%-7% (13,14). The direct cost associated with a CSPEB of LNPCLs is estimated to be at least 3 times higher than the cost of an uncomplicated EMR, in a European context (10,15).…”

Section: Introductionmentioning

confidence: 99%

Preventing Postendoscopic Mucosal Resection Bleeding of Large Nonpedunculated Colorectal Lesions

et al. 2022

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The most common major adverse event of endoscopic mucosal resection (EMR) is clinically significant post-EMR bleeding (CSPEB), with an incidence of 6%-7% in large lesions. Repeat colonoscopy, blood transfusions, or other interventions are often needed. The associated direct costs are much higher than those of an uncomplicated EMR. In this review, we discuss the aspects related to CSPEB of large nonpedunculated polyps, such as risk factors, predictive models, and prophylactic measures, and we highlight evidence for preventive treatment options and explore new methods for bleeding prophylaxis. We also provide recommendations for steps that can be taken before, during, and after EMR to minimize bleeding risk. Finally, this review proposes future directions to reduce CSPEB incidence.

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Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives

Abstract: Standard direct cost of the majority of AEP is reported using a methodology that enables easy application in other centers. For the most part, endoscopic procedures are more cost-efficient than the corresponding surgical procedure.

Cited by 17 publications

References 21 publications

Centers of Excellence Implementation for Treating Rheumatoid Arthritis in Colombia: A Cost-Analysis

Centers of Excellence Implementation for Treating Rheumatoid Arthritis in Colombia: A Cost-Analysis

Choledochoscopy: An update

Preventing Postendoscopic Mucosal Resection Bleeding of Large Nonpedunculated Colorectal Lesions

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