Comparison of cost affecting parameters and costs of the "closed" and "open" in situ bypass technique.
OBJECTIVE
The "closed" in situ bypass results in a reduction of wound complications compared to the "open" technique. This advantage is partly diminished by extra costs for the "closed" procedure and a larger percentage of residual arteriovenous (AV)-fistulae. This aim of this study was to analyse costs related to "closed" and "open" procedures.


METHODS
The cost affecting parameters: (1) duration of operation; (2) length of hospital stay; and (3) number of treated residual AV-fistulae, were analysed in a randomised group of 73 patients (35 "closed" and 38 "open") in two centres. In addition, costs of the operation, nursing care and treatment of AV-fistulae were analysed.


RESULTS
The "closed" and "open" group showed a median duration of operation of 210 min (range 105-570) and 154 min (range 90-355) (p < 0.05), length of hospital stay of 16 days (range 5-51) and 25 days (range 12-65) (p < 0.01), and a percentage of patients treated for residual AV-fistulae of 40% and 5%, respectively (p < 0.01). The median "closed" operation was US$798 more expensive than the "open". Median postoperative care was US$2664 less for the "closed" group. Mean estimated costs for treatment of AV-fistulae was US$9 in the "open" and US$167 in the "closed" group.


CONCLUSIONS
The "closed" in situ vein bypass technique is cost-effective in comparison with the "open" technique.
van Dijk
L C
LC
Department of Radiology, University Hospital Rotterdam Dijkzigt, The Netherlands.
Seerden
R
R
van Urk
H
H
Wittens
C H
CH
D000368:Aged; D001164:Arteriovenous Fistula / Q000451:nursing / Q000601:surgery / Q000628:therapy; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D004180:Direct Service Costs; D004471:Economics, Nursing; D004621:Embolization, Therapeutic / Q000191:economics / Q000379:methods / Q000451:nursing; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007511:Ischemia / Q000451:nursing / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D007902:Length of Stay / Q000191:economics; D008026:Ligation / Q000191:economics / Q000451:nursing; D008297:Male; D009732:Nursing Care; D011183:Postoperative Complications / Q000517:prevention & control; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000191:economics