Table 3 |
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|
Summary of sensitivity analyses: mean total costs and estimated absolute and relative differences between relaparotomy on demand and planned relaparotomy across alternative assumptions and calculation methods |
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|
Mean |
Mean |
% |
||||
|
Description |
OD |
PR |
difference |
95% CIa |
Difference |
|
|
|
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|
Analysis |
||||||
|
Main |
Main analysis (most probable assumptions) |
65,768 |
83,450 |
17,682 |
(5,062 to 29,004) |
21.2% |
|
1 |
Percutaneous drainage procedures (reimbursement fee as opposed to AMC estimate) |
65,754 |
83,428 |
17,674 |
(5,057 to 28,975) |
21.2% |
|
2 |
Ward-stay unit costs (weighted average of Academic and General hospitals)b |
62,938 |
81,016 |
18,078 |
(5,437 to 28,640) |
22.3% |
|
3 |
ICU-day unit costs (AMC top-down calculation instead of guideline) |
70,694 |
90,980 |
20,286 |
(5,959 to 32,160) |
22.3% |
|
4 |
With ICU-day unit costs estimated for |
|||||
|
A United Kingdom |
63,235 |
79,688 |
16,453 |
(4,788 to 28,439) |
20.6% |
|
|
B Germany |
61,541 |
77,172 |
15,631 |
(4,578 to 28,037) |
20.3% |
|
|
C France |
69,102 |
88,401 |
19,299 |
(5,371 to 29,721) |
21.8% |
|
|
D Norway |
77,225 |
100,465 |
23,240 |
(5,948 to 31,306) |
23.1% |
|
|
E Austria |
63,794 |
80,518 |
16,724 |
(4,851 to 28,560) |
20.8% |
|
|
F Canada |
58,960 |
73,338 |
14,378 |
(4,223 to 27,415) |
19.6% |
|
|
5 |
Exclude all costs of relaparatomy procedures |
62,543 |
77,913 |
15,370 |
(3,018 to 25,395) |
19.7% |
|
|
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|
aBased on geometric means; bweighted by ratio of Academic and General hospital beds in the Netherlands (1:6). Explanation of different sensitivity analyses: (1) for percutaneous drainage procedure, AMC-unit costs estimates were replaced by reimbursement fees for this procedure. (2) To avoid the encountered cost differences where direct results from the differentiation between academic and nonacademic hospitals, a weighted average unit cost per hospital ward day was used. This average was weighted by the actual ratio of academic and nonacademic hospital beds in the Netherlands [29]. (3) We differentiated between unit costs of relaparotomies with and those without other surgical procedures (such as enterostomy (re)construction, abscess drainage, colon resection) instead of using the same all-in unit costs for all relaparotomies. (4a through f) To enhance generalizability of the results to other countries with publicly financed health care systems, Dutch reference prices for ICU days were replaced by unit costs estimated for the UK, Germany, France, Norway, Austria, and Canada, respectively [10,19-23]. Additionally (5), we compared the total costs of the two strategies when disregarding the costs of relaparotomy procedures during the index admission because these differences were intrinsic to the strategy itself, as the planned strategy involved more procedures than did the on-demand strategy. |
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|
Opmeer et al. Critical Care 2010 14:R97 doi:10.1186/cc9032 |
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