[Costs of diagnosis and treatment for pulmonary embolism lower due to application of consensus strategy].
OBJECTIVE
To compare the costs of diagnosis and treatment of patients clinically suspected of pulmonary embolism, before and after the adoption of the Dutch consensus for the diagnosis of pulmonary embolism.


METHODS
Study of the records, followed by a prospective study with a follow-up lasting 6 months.


METHODS
Academic Medical Centre and Slotervaart Hospital, Amsterdam, the Netherlands.


METHODS
Data were collected on 120 patients from the preconsensus period and on 452 patients examined according to the consensus strategy. This established the average patterns of medical consumption of patients before and after adoption of consensus. The mean costs per patient were then estimated.


RESULTS
Diagnosis and treatment of a patient according to the consensus strategy on the basis of our estimates were considerably less expensive than non-protocolled diagnosis and treatment (Dfl. 4,413 as against Dfl. 5,115 per patient). This difference mainly resulted from shorter hospital stays owing to more rapid completion of the diagnosis. Considering the large number of annual hospital admissions in the Netherlands in connection with this diagnosis, savings of up to Dfl. 26 million would appear possible if the consensus were followed nationwide.


CONCLUSIONS
Considerable amounts are involved in the diagnosis and treatment of pulmonary embolism in the Netherlands. Accordingly, further research into possibilities to make these more efficient would appear advisable.
Michel
B C
BC
Erasmus Universiteit, Instituut voor Medische Technology Assessment, Rotterdam.
Seerden
R J
RJ
van Beek
E J
EJ
Büller
H R
HR
Rutten
F F
FF
D002985:Clinical Protocols; D015897:Comorbidity; D003363:Cost Control; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009426:Netherlands; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000191:economics* / Q000628:therapy*