title: Hospital versus home treatment of deep vein thrombosis in a tertiary care hospital in Saudi Arabia: Are we ready?
abstract: OBJECTIVE
  Treatment of DVT with LMWHs has been shown recently to be as effective as UFH with suggested lower costs. This study was conducted to determine and compare the cost of in-patient hospital treatment versus outpatient hospital treatment of patients with DVT.
  
  
  METHODS
  All adult patients with acute proximal DVT referred to the Emergency Department of King Khalid University Hospital, Riyadh, Saudi Arabia between August 2009 and August 2010 were invited to the study. An economic analysis was performed to compare the cost impact of outpatients versus hospital treatment.
  
  
  RESULTS
  Sixty-one patients were included in the study, 31 were followed in the outpatient setting and 30 as the control group (inpatients). There were no significant differences in the outcome between the outpatient and inpatient group; three patients (9.7%) in the outpatient group and four patients (13.3%) in the inpatient group had recurrent DVT. Mean nursing cost was $55 for the outpatient group and $215 for the inpatient group, mean laboratory monitoring cost was $638 for outpatient group and $1511 for the inpatient group. Hospital stay and doctor's fees amounted to a mean of $1000 for outpatient treatment and $2387 for inpatient treatment, p < 0.0001. The mean outpatient cost was significantly lower than the inpatient cost ($1750 vs. $4338, p < 0.0001).
  
  
  CONCLUSIONS
  Outpatient treatment of patients with DVT using LMWHs is cost-effective with no significant differences in the outcome of patients. OPD treatment of DVT is feasible in Saudi Arabia provided there is enough logistic support from thrombosis clinics and those involved in DVT care.
authors: Hematology-Oncology Division, Department of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors: Farjah
authors: F
authors: Algahtani
authors: Zohair Al
authors: ZA
authors: Aseri
authors: Abdurahman
authors: A
authors: Aldiab
authors: Aamer
authors: A
authors: Aleem
keywords: Anticoagulation; Deep vein thrombosis; Economic evaluation; Outpatient; Patient safety; Treatment
references: Thromb Haemost. 1998 Feb;79(2):259-63
references: 9493572
references: Arch Intern Med. 1993 Jul 12;153(13):1541-6
references: 8391792
references: Arch Intern Med. 1998 Mar 23;158(6):585-93
references: 9521222
references: Ann Intern Med. 1999 May 18;130(10):789-99
references: 10366368
references: BMJ. 1994 Jul 30;309(6950):299-304
references: 8086867
references: Am J Cardiol. 2004 Jan 15;93(2):259-62
references: 14715365
references: Ann Intern Med. 2001 Feb 6;134(3):191-202
references: 11177331
references: Thromb Res Suppl. 1991;14:49-62
references: 1658970
references: Arch Intern Med. 1999 May 24;159(10):1139-40
references: 10335693
references: N Engl J Med. 1991 May 30;324(22):1565-74
references: 2027360
references: J Intern Med. 1992 Aug;232(2):155-60
references: 1506812
references: Circulation. 1976 Apr;53(4):691-5
references: 1253392
references: Thromb Haemost. 1996 Aug;76(2):195-9
references: 8865530
references: Lancet. 1992 Feb 22;339(8791):441-5
references: 1346817
references: Angiology. 1999 Oct;50(10):781-7
references: 10535716
references: Thromb Haemost. 1994 Aug;72(2):186-90
references: 7831649
references: J Intern Med. 1996 Dec;240(6):395-401
references: 9010387
references: Arch Intern Med. 1995 Mar 27;155(6):601-7
references: 7887755
references: Arch Intern Med. 2000 Oct 23;160(19):2926-32
references: 11041899
references: Arch Intern Med. 1997 Dec 8-22;157(22):2562-8
references: 9531224
references: N Engl J Med. 1997 Sep 4;337(10):657-62
references: 9280815
references: N Engl J Med. 1992 Apr 9;326(15):975-82
references: 1545850
references: Am J Med. 1996 Mar;100(3):269-77
references: 8629671