Hospitalization for pelvic inflammatory disease: a cost-effectiveness analysis.
OBJECTIVE
Nulliparous women are frequently hospitalized for treatment of pelvic inflammatory disease (PID).


OBJECTIVE
The goal of this study was to determine the economic feasibility of hospitalizing adolescents and young women for PID.


METHODS
The authors conducted a Markov decision model, estimating the cost-effectiveness of hospitalization compared with outpatient therapy for mild to moderate PID for adolescents and young women, calculating costs per quality-adjusted life-year (QALY) gained under various assumptions about hospitalization effects on complications.


RESULTS
If hospitalization decreases PID complications by 10%, 20%, or 30%, the cost/QALY gained is 145,000 dollars, 67,400 dollars, or 42,400 dollars, respectively, compared with outpatient therapy. Assumptions about hospitalization effects on the development of chronic pelvic pain heavily weight the analysis; costs/QALY gained by hospitalization increase considerably if chronic pain is unaffected.


CONCLUSIONS
Hospitalization for PID treatment to possibly preserve fertility in nulliparous young women and adolescents is unlikely to be economically reasonable even if substantial improvements in PID complication rates are assumed.
Smith
Kenneth J
KJ
Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. smithkj2@upmc.edu
Ness
Roberta B
RB
Roberts
Mark S
MS
D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008390:Markov Chains; D000292:Pelvic Inflammatory Disease / Q000191:economics* / Q000628:therapy*; D019057:Quality-Adjusted Life Years