title: Management of malignant pleural effusion by an indwelling pleural catheter: A cost-efficiency analysis.
abstract: BACKGROUND
  For patients that are expected to survive for longer, the risk of complications combined with the need for more vacuum drainage bottles have become barriers to the placement of indwelling pleural catheter (IPC), since these could increase costs.
  
  
  OBJECTIVE
  The objective of the current article is to determine the cost and efficiency of treating malignant pleural effusion (MPE) with IPC in Spanish hospitals.
  
  
  METHODS
  We compared the cost associated with the use of IPC per outpatient and per inpatient. We analyzed the number of consultations, length of hospital stay, and outcome of the procedure.
  
  
  RESULTS
  Fifty-five patients were recruited. Spontaneous pleurodesis was achieved in 34.4% of the cases. Post-catheterization complications were observed in 7.2%. Supplementary procedures were unnecessary and 87.7% of the patients reported improved dyspnea. In 64.9% of the cases, the IPCs were inserted during hospitalization with a median hospitalization time of 4 days (1-7.5). There were differences in the number of visits with more consultations being observed in the outpatient group. There was no difference in the number of vacuum drainage bottles used. The complications supposed a cost increase of €1045.6 per outpatient and €432.54 per inpatient. The overall average cost of treatment per outpatient was €3310.2 and €5450.3 per inpatient.
  
  
  CONCLUSIONS
  The treatment with IPC was effective, safe, without need of any more procedures and led to improved dyspnea in more than 85% of the patients. The cost is lower in the outpatient group, although complications represent an increased cost in both groups.
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Respiratory and Infectious Disease Research Group, Bio-medical Research Institute of Vigo (IBIV), Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain.
authors.forename: Maribel Botana
authors.initials: MB
authors.lastname: Rial
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Complexo Hospitalario Universitario de Ourense (CHOU), Ourense, Spain.
authors.forename: Isaura Parente
authors.initials: IP
authors.lastname: Lamela
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Respiratory and Infectious Disease Research Group, Bio-medical Research Institute of Vigo (IBIV), Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain.
authors.forename: Virginia Leiro
authors.initials: VL
authors.lastname: Fernández
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Complexo Hospitalario Universitario de Ourense (CHOU), Ourense, Spain.
authors.forename: José Abal
authors.initials: JA
authors.lastname: Arca
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Respiratory and Infectious Disease Research Group, Bio-medical Research Institute of Vigo (IBIV), Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain.
authors.forename: Manuel Núñez
authors.initials: MN
authors.lastname: Delgado
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Respiratory and Infectious Disease Research Group, Bio-medical Research Institute of Vigo (IBIV), Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain.
authors.forename: Carlos Vilariño
authors.initials: CV
authors.lastname: Pombo
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Respiratory and Infectious Disease Research Group, Bio-medical Research Institute of Vigo (IBIV), Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain.
authors.forename: Cristina Ramos
authors.initials: CR
authors.lastname: Hernández
authors.affiliation: Department of Pneumology, Bronchopleural Unit, Respiratory and Infectious Disease Research Group, Bio-medical Research Institute of Vigo (IBIV), Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández-Villar
keywords: Costs; efficiency; indwelling pleural catheters; pleural malignant effusion