title: Real-world economic burden of venous thromboembolism and antithrombotic prophylaxis in medical inpatients.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in medical patients, and the economic burden of this disease is plausibly relevant as well. However, few data from real-world observations are available on this topic. Aim of our study was to assess the costs of VTE management and antithrombotic prophylaxis in patients hospitalized in Internal Medicine (IM) departments.
  
  
  METHODS
  The in-hospital paths of 160 patients with VTE (VTE group) and 160 patients receiving prophylaxis and without VTE (NO-VTE group) were retrospectively evaluated within 26IM units in Italy. The economic analysis was undertaken by applying a process analysis, the initial phase of the more comprehensive Activity Based Costing technique. Accordingly to this approach, only information closely linked to VTE or its prevention was registered.
  
  
  RESULTS
  The total median costs for VTE management were around four-times higher than those for prophylaxis (€ 1,348.68 vs € 373.03). Human resources were the most important cost-driver (55.5% and 65.7% in the VTE and NO-VTE groups), followed by instrumental (24.6% in VTE and 15.5% in NO-VTE) and haematologic tests (12.6% in VTE patients and 13.3% in controls). In the NO-VTE group the direct costs for prophylaxis accounted for 4.5% of total.
  
  
  CONCLUSIONS
  The real-world data of this study confirm the economic burden of in-hospital treatment of VTE, and the relatively low costs of thromboprophylaxis. A greater adherence to evidence-based protocols for VTE prevention could probably reduce the current financial burden of VTE on healthcare systems.
authors.affiliation: Research Department, FADOI Foundation, Milan, Italy.
authors.forename: Gualberto
authors.initials: G
authors.lastname: Gussoni
authors.forename: Emanuela
authors.initials: E
authors.lastname: Foglia
authors.forename: Stefania
authors.initials: S
authors.lastname: Frasson
authors.forename: Luca
authors.initials: L
authors.lastname: Casartelli
authors.forename: Mauro
authors.initials: M
authors.lastname: Campanini
authors.forename: Marzia
authors.initials: M
authors.lastname: Bonfanti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Colombo
authors.forename: Emanuele
authors.initials: E
authors.lastname: Porazzi
authors.forename: Walter
authors.initials: W
authors.lastname: Ageno
authors.forename: Giorgio
authors.initials: G
authors.lastname: Vescovo
authors.forename: Antonino
authors.initials: A
authors.lastname: Mazzone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics; D016527:Drug Costs; D005260:Female; D005343:Fibrinolytic Agents / Q000191:economics* / Q000627:therapeutic use*; D019983:Guideline Adherence; D017721:Hospital Costs; D006757:Hospital Units / Q000191:economics; D006801:Humans; D007297:Inpatients; D007388:Internal Medicine / Q000191:economics; D007558:Italy; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D017410:Practice Guidelines as Topic; D011314:Preventive Health Services / Q000191:economics*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents