[Cost-effectiveness of the deep vein thrombosis diagnosis process in primary care]. / Estudio coste efectividad del proceso diagnóstico de la trombosis venosa profunda desde la atención primaria.
Aten Primaria
; 48(4): 251-7, 2016 Apr.
Article
em Es
| MEDLINE
| ID: mdl-26298874
ABSTRACT
OBJECTIVE:
To analyse the cost effectiveness of the application of diagnostic algorithms in patients with a first episode of suspected deep vein thrombosis (DVT) in Primary Care compared with systematic referral to specialised centres.DESIGN:
Observational, cross-sectional, analytical study. LOCATION Patients from hospital emergency rooms referred from Primary Care to complete clinical evaluation and diagnosis.PARTICIPANTS:
A total of 138 patients with symptoms of a first episode of DVT were recruited; 22 were excluded (no Primary Care report, symptoms for more than 30 days, anticoagulant treatment, and previous DVT). Of the 116 patients finally included, 61% women and the mean age was 71 years. MAIN MEASUREMENTS Variables from the Wells and Oudega clinical probability scales, D-dimer (portable and hospital), Doppler ultrasound, and direct costs generated by the three algorithms analysed all patients were referred systematically, referral according to Wells and Oudega scale.RESULTS:
DVT was confirmed in 18.9%. The two clinical probability scales showed a sensitivity of 100% (95% CI 85.1 to 100) and a specificity of about 40%. With the application of the scales, one third of all referrals to hospital emergency rooms could have been avoided (P<.001). The diagnostic cost could have been reduced by 8,620 according to Oudega and 9,741 according to Wells, per 100 patients visited.CONCLUSION:
The application of diagnostic algorithms when a DVT is suspected could lead to better diagnostic management by physicians, and a more cost effective process.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Algoritmos
/
Trombose Venosa
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
Es
Revista:
Aten Primaria
Ano de publicação:
2016
Tipo de documento:
Article