Variation in medical resource utilisation in the management of pulmonary embolism in Belgium.
The objective of this study was to investigate, through a patient chart analysis, the average and the variation in the medical resource use in pulmonary embolism (PE) patients in Belgium, and to find explanatory variables for the possible variation. A sample of patients with confirmed PE (n = 54) from 5 centres was selected. The centres were representative for size and region. The charts were selected at random after applying a set of exclusion criteria, in order to avoid heterogeneity of the sample characteristics. Charts were analysed using a standardised case report form, and medical resource use was collected by an independent researcher. Only medical resources related to the PE were included. On average, it appeared that the management of PE was fairly consistent between the different centres. The total average cost of PE was [symbol: see text] 3394 (St. Err. = [symbol: see text] 323). Nevertheless, large differences were found in the number of diagnostic and follow-up tests. Also, a wide variation in duration of hospital stay was found (average = 14.6, p75-p25 = 9.0), but this effect was not explained by the type of centre nor the region. The two factors that explain duration of hospital stay are the number of days of IV heparin use and the intensity of diagnostic follow-up, as expressed by the number of VQ-scans.
Annemans
L
L
Ghent University Hospital.
Robays
H
H
Bruart
J
J
Verstraeten
P
P
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001530:Belgium; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006493:Heparin / Q000627:therapeutic use; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000191:economics / Q000628:therapy*
D000925:Anticoagulants; D006493:Heparin