HOSPITAL BURDEN 18 MONTHS AFTER SURGICAL TREATMENT OF FUNCTIONAL MENORRHAGIA IN FRANCE
Author(s)
de Léotoing L1, Chaize G2, Fernandes J3, Roussel V4, Lafon T2, Lamarsalle L1, Fernandez H5
1HEVA, LYON, France, 2HEVA, Lyon, France, 3Oc-Santé, Montpellier, France, 4Hologic, Roissy CDG Cedex, France, 5Hôpital Bicêtre, Le Kremlin-Bicêtre, France
OBJECTIVES: To assess the current hospital burden of functional menorrhagia surgically treated in France. METHODS: A retrospective database analysis was performed using the French exhaustive national hospital discharge database (PMSI). All hospital stays from 2009 to 2015 with 4 types of menorrhagia surgery identified by CCAM codes associated with ICD-10 codes were extracted: 2nd generation (2G), 1st generation (1G), curettage, hysterectomy. Only incident 35-55 year-old women were analyzed (no surgery since 2006). An algorithm was completed with the medical input of experts in order to exclude any patient identified as presenting comorbidities that would introduce bias in the results (breast or colorectal cancer, myoma, endometriosis…). Patients operated on before 2014/06/30 were followed at least 18 months from their surgery. Another algorithm and a medical review identified rehospitalizations related to surgery failure or complication. Hospital costs associated with these patients were estimated using the French official tariffs expressed in 2017 Euro. RESULTS: The 18-month failure rate ran from 2.8% for hysterectomy to 9.9% for 2G, 12.7% for 1G and 20.6% for curettage, whereas the 18-month complication rate was 1.4% for curettage, 1.5% for 1G, 1.9% for 2G and 5.3% for hysterectomy. The trend was similar at 24 and 60 months. The 18-month median cost per patient varied from €782 [Q1 741-Q3 2,732] for curettage to €1,059 [913-2,075] for 1G, €1,173 [1,002-2,231] for 2G, €3,090 [2,909-4,189] for hysterectomy. CONCLUSIONS: This study shows that mini-invasive 1G and 2G techniques low complication rates and costs are in line with their recommended use at first stage.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PIH9
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Reproductive and Sexual Health