Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure
Main Author: | |
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Publication Date: | 2010 |
Other Authors: | , , , , |
Format: | Article |
Language: | eng |
Source: | Arquivos de gastroenterologia (Online) |
Download full: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032010000200008 |
Summary: | CONTEXT: Studies in the area of health economics are still poorly explored and it is known that the cost savings in this area is becoming more necessary, provided that strict criteria. OBJECTIVE: To perform a cost-effectiveness analysis of spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure. METHODS: This was a randomized clinical trial with 50 patients undergoing loop colostomy closure either under spinal anesthesia (n = 25) or under local anesthesia plus sedation (n = 25). The duration of the operation, time spent in the post-anesthesia recovery room, pain, postoperative complications, length of hospital stay, laboratory and imaging examinations and need for rehospitalization and reoperation were analyzed. The direct medical costs were analyzed. A decision tree model was constructed. The outcome measures were mean cost and cost per local and systemic postoperative complications avoided. Incremental cost-effectiveness ratios were presented. RESULTS: Duration of operation: 146 ± 111.5 min. vs 105 ± 23.6 min. (P = 0.012); mean time spent in post-anesthesia recovery room: 145 ± 110.8 min. vs 36.8 ± 34.6 min. (P<0.001). Immediate postoperative pain was lower with local anesthesia plus sedation (P<0.05). Local and systemic complications were fewer with local anesthesia plus sedation (P = 0.209). Hospitalization + rehospitalization: 4.5 ± 4.1 days vs 2.9 ± 2.2 days (P<0.0001); mean spending per patient: R$ 5,038.05 vs 2,665.57 (P<0.001). Incremental cost-effectiveness ratio: R$ -474.78, indicating that the strategy with local anesthesia plus sedation is cost saving. CONCLUSION: In the present investigation, loop colostomy closure under local anesthesia plus sedation was effective and appeared to be a dominant strategy, compared with the same surgical procedure under spinal anesthesia. |
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Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closureColostomyAnesthesia, localAnesthesia, spinalConcious sedationCosts and cost analysisCONTEXT: Studies in the area of health economics are still poorly explored and it is known that the cost savings in this area is becoming more necessary, provided that strict criteria. OBJECTIVE: To perform a cost-effectiveness analysis of spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure. METHODS: This was a randomized clinical trial with 50 patients undergoing loop colostomy closure either under spinal anesthesia (n = 25) or under local anesthesia plus sedation (n = 25). The duration of the operation, time spent in the post-anesthesia recovery room, pain, postoperative complications, length of hospital stay, laboratory and imaging examinations and need for rehospitalization and reoperation were analyzed. The direct medical costs were analyzed. A decision tree model was constructed. The outcome measures were mean cost and cost per local and systemic postoperative complications avoided. Incremental cost-effectiveness ratios were presented. RESULTS: Duration of operation: 146 ± 111.5 min. vs 105 ± 23.6 min. (P = 0.012); mean time spent in post-anesthesia recovery room: 145 ± 110.8 min. vs 36.8 ± 34.6 min. (P<0.001). Immediate postoperative pain was lower with local anesthesia plus sedation (P<0.05). Local and systemic complications were fewer with local anesthesia plus sedation (P = 0.209). Hospitalization + rehospitalization: 4.5 ± 4.1 days vs 2.9 ± 2.2 days (P<0.0001); mean spending per patient: R$ 5,038.05 vs 2,665.57 (P<0.001). Incremental cost-effectiveness ratio: R$ -474.78, indicating that the strategy with local anesthesia plus sedation is cost saving. CONCLUSION: In the present investigation, loop colostomy closure under local anesthesia plus sedation was effective and appeared to be a dominant strategy, compared with the same surgical procedure under spinal anesthesia.Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. 2010-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032010000200008Arquivos de Gastroenterologia v.47 n.2 2010reponame:Arquivos de gastroenterologia (Online)instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiainstacron:IBEPEGE10.1590/S0004-28032010000200008info:eu-repo/semantics/openAccessVaz,Filinto Aníbal AlagiaAbreu,Rone Antônio AlvesSoárez,Patrícia Coelho deSperanzini,Manlio BasílioFernandes,Luís CesarMatos,Delcioeng2010-09-22T00:00:00Zoai:scielo:S0004-28032010000200008Revistahttp://www.scielo.br/aghttps://old.scielo.br/oai/scielo-oai.php||secretariaarqgastr@hospitaligesp.com.br1678-42190004-2803opendoar:2010-09-22T00:00Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiafalse |
dc.title.none.fl_str_mv |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure |
title |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure |
spellingShingle |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure Vaz,Filinto Aníbal Alagia Colostomy Anesthesia, local Anesthesia, spinal Concious sedation Costs and cost analysis |
title_short |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure |
title_full |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure |
title_fullStr |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure |
title_full_unstemmed |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure |
title_sort |
Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure |
author |
Vaz,Filinto Aníbal Alagia |
author_facet |
Vaz,Filinto Aníbal Alagia Abreu,Rone Antônio Alves Soárez,Patrícia Coelho de Speranzini,Manlio Basílio Fernandes,Luís Cesar Matos,Delcio |
author_role |
author |
author2 |
Abreu,Rone Antônio Alves Soárez,Patrícia Coelho de Speranzini,Manlio Basílio Fernandes,Luís Cesar Matos,Delcio |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Vaz,Filinto Aníbal Alagia Abreu,Rone Antônio Alves Soárez,Patrícia Coelho de Speranzini,Manlio Basílio Fernandes,Luís Cesar Matos,Delcio |
dc.subject.por.fl_str_mv |
Colostomy Anesthesia, local Anesthesia, spinal Concious sedation Costs and cost analysis |
topic |
Colostomy Anesthesia, local Anesthesia, spinal Concious sedation Costs and cost analysis |
description |
CONTEXT: Studies in the area of health economics are still poorly explored and it is known that the cost savings in this area is becoming more necessary, provided that strict criteria. OBJECTIVE: To perform a cost-effectiveness analysis of spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure. METHODS: This was a randomized clinical trial with 50 patients undergoing loop colostomy closure either under spinal anesthesia (n = 25) or under local anesthesia plus sedation (n = 25). The duration of the operation, time spent in the post-anesthesia recovery room, pain, postoperative complications, length of hospital stay, laboratory and imaging examinations and need for rehospitalization and reoperation were analyzed. The direct medical costs were analyzed. A decision tree model was constructed. The outcome measures were mean cost and cost per local and systemic postoperative complications avoided. Incremental cost-effectiveness ratios were presented. RESULTS: Duration of operation: 146 ± 111.5 min. vs 105 ± 23.6 min. (P = 0.012); mean time spent in post-anesthesia recovery room: 145 ± 110.8 min. vs 36.8 ± 34.6 min. (P<0.001). Immediate postoperative pain was lower with local anesthesia plus sedation (P<0.05). Local and systemic complications were fewer with local anesthesia plus sedation (P = 0.209). Hospitalization + rehospitalization: 4.5 ± 4.1 days vs 2.9 ± 2.2 days (P<0.0001); mean spending per patient: R$ 5,038.05 vs 2,665.57 (P<0.001). Incremental cost-effectiveness ratio: R$ -474.78, indicating that the strategy with local anesthesia plus sedation is cost saving. CONCLUSION: In the present investigation, loop colostomy closure under local anesthesia plus sedation was effective and appeared to be a dominant strategy, compared with the same surgical procedure under spinal anesthesia. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032010000200008 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032010000200008 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0004-28032010000200008 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. |
publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. |
dc.source.none.fl_str_mv |
Arquivos de Gastroenterologia v.47 n.2 2010 reponame:Arquivos de gastroenterologia (Online) instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia instacron:IBEPEGE |
instname_str |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia |
instacron_str |
IBEPEGE |
institution |
IBEPEGE |
reponame_str |
Arquivos de gastroenterologia (Online) |
collection |
Arquivos de gastroenterologia (Online) |
repository.name.fl_str_mv |
Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia |
repository.mail.fl_str_mv |
||secretariaarqgastr@hospitaligesp.com.br |
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1754193345512472576 |