[Cost efficiency study of lacrimal canal obstruction treatment].
OBJECTIVE
To compare three methods used to clear the lacrimal canal.


METHODS
A total of 32 files (20 for the dacryocysto-rhinostomy by endoscopic way, 5 for the dacryocysto-rhinostomy by external way and 7 cases of percutaneous stenting) were reviewed. For each, costs of performed interventions were reviewed. An average of the total cost per patient was calculated for all three methods and was then correlated to the initial efficiency of the method.


RESULTS
Results show that the average cost for stenting is up to 1,366.80 EUR, for the endoscopic way is up to 2 001.53 EUR and for the external way is up to 2,220.46 EUR. ANOVA (Analysis of Variance) gives significant results when comparing stent to endoscopic way (p=0.000007) and to the external way (p =0.02). The analysis of sensitivity concerning the success rate of various treatments shows that the stent was potentially the most cost-effective and that a failure rate of 35.1% is rather acceptable by comparison to the endoscopic method. If the stent is considered as an outpatient intervention, then, a failure rate of 50% is acceptable.


CONCLUSIONS
If the failure rate stays under 35.1%, the stent may be considered as a short-term cost-effective method.
Gerbaud
L
L
Services d'Epidémiologie, d'Economie de la Santé de Prévention, CHU de Clermont-Ferrand.
Chiambaretta
F
F
Desrumeaux
H
H
Privat
C
C
Doz
M
M
Menerath
J M
JM
Guichard
C
C
Garcier
J M
JM
Boyer
L
L
D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000379:methods; D000704:Analysis of Variance; D003362:Cost-Benefit Analysis; D003608:Dacryocystorhinostomy / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D004180:Direct Service Costs / Q000706:statistics & numerical data; D004724:Endoscopy / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D012189:Retrospective Studies; D015607:Stents / Q000191:economics; D016896:Treatment Outcome