Cost-utility of breast reduction surgery--a prospective study.
OBJECTIVE
To assess the cost-utility of routine breast-reduction surgery in the setting of a large university hospital.


METHODS
In the framework of a large trial exploring the feasibility of routine health-related quality of life (HRQoL) assessment, 80 patients (mean age: 45 years) entering the Department of Plastic Surgery for operative breast reduction filled in the 15-dimension (15D) HRQoL survey before and 6 months after surgery. Data on hospital costs were obtained from the hospital records.


RESULTS
Mean (+/-SD) HRQoL score (on a 0-1 scale) increased as a result of surgery from the preoperative 0.916+/-0.075 to 0.939+/-0.076 (p<0.001) 6 months after surgery, corresponding to a mean (+/-SD) gain of 0.930+/-2.117 quality-adjusted life years (QALYs). Of the 15 health dimensions, discomfort and symptoms showed the greatest improvement (p<0.001). A statistically significant improvement was also seen on the dimensions of breathing, sleeping and distress. Mean hospital cost of treatment was 3383 euro+/-1744, and the cost per QALY was 3638 euro. Using 5% discounting for QALYs, the cost per QALY increased to 8973 euro.


CONCLUSIONS
Breast-reduction surgery improved HRQoL in a statistically significant manner and at a reasonable cost, as the cost per QALY was in the same range as that observed in our material, for example, for hip-replacement surgery.
Tykkä
E
E
Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland. erika.tykka@hus.fi
Räsänen
P
P
Tukiainen
E
E
Asko-Seljavaara
S
S
Heikkilä
A
A
Sintonen
H
H
Roine
R P
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D017721:Hospital Costs; D006801:Humans; D016462:Mammaplasty / Q000191:economics* / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires