title: Effects of introducing a clinical guideline on the cost of treating dyspeptic syndrome.
abstract: This review highlights the effects incurred on pharmacoutilization and the total expenses for dyspeptic syndrome by the introduction of a clinical guideline. A retrospective method of reading an administrative billing database in the Ravenna (Italy) local health unit was performed for all subjects who were health-assisted by ten general practitioners. They had previously developed and agreed to a clinical guideline to manage dyspeptic syndrome patients (study group) and a group of 30 self-regulating general practitioners patients (control group). Patients were classified as dyspeptic according to the presence of at least one prescription for antidyspeptic drugs during a 365-day follow-up period. The cost for drugs, hospitalizations, emergency room accesses and gastroscopies was recorded. The results showed that a total of 51,904 subjects were enrolled: 23.1% by the study general practitioners and 76.9% by the control general practitioners. The percentage of dyspeptic patients accounted for 17.6 and 15.0% in the subjects enrolled in the study and control groups. The total average cost of the dyspeptic patients was less in the study than in the control group (euro163.41 vs. 181.39; p = 0.043). This difference is mainly due to the cost of hospitalization (euro94.55 in the study and euro110.92 in the control group; p = 0.012). The significant results of the introduction of a guideline for the treatment of dyspeptic syndrome into clinical practice were an increase in the use of pharmacological treatment and a decrease in the cost of treatment per patient.
authors.affiliation: CliCon Srl., Via San Vitale 5, 48100 Ravenna, Italy. mailbox@clicon.it
authors.forename: Luca
authors.initials: L
authors.lastname: Degli Esposti
authors.forename: Omero
authors.initials: O
authors.lastname: Triossi
authors.forename: Giorgia
authors.initials: G
authors.lastname: Valpiani
authors.forename: Stefania
authors.initials: S
authors.lastname: Saragoni
authors.forename: Leonardo
authors.initials: L
authors.lastname: Ottaviano
authors.forename: Ezio
authors.initials: E
authors.lastname: Degli Esposti