Economic evaluation of six scenarios for the treatment of stones in the kidney and ureter by surgery or extra-corporeal shock wave lithotripsy.
Health policy makers in the U.K. have had to respond to the advent of a new, high technology, method of treating stones. In order to assist the definition of an appropriate policy this evaluative study of the new technique was undertaken. The economic benefits of extracorporeal shock wave lithotripsy (ESWL) were compared with those of conventional open surgery for the treatment of upper urinary tract stones considering 6 possible 'scenarios', or intuitively plausible combinations of prices and levels of diffusion. It was concluded that second generation ESWL machines operated and financed at designated 'stone coalitions of health regions for a supra-regional population of about 12-15 million would be the most cost efficient option. Use of the currently available Dornier machine on the same supra-regional basis would be the, somewhat more expensive, second best option. These results, along with a range of supplementary documentation, were presented to both the national Department of Health and Social Security, and to the North Western Regional Health Authority. The NWRHA in turn presented its case to a supra-regional committee. The most cost-effective solution was adopted by this supra-regional committee.
D003365:Costs and Cost Analysis; D006748:Hospital Departments / Q000191:economics*; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000191:economics*; D013223:Statistics as Topic; D013503:Surgery Department, Hospital / Q000191:economics*; D013673:Technology Assessment, Biomedical / Q000191:economics*; D006113:United Kingdom; D014545:Urinary Calculi / Q000628:therapy*; D026712:Value of Life