Health care costs are an increasingly important study outcome. Endoscopic pra ctice consumes a large proportion of gastroenterology- related health expenses. An economic comparison of several currently accepted endosc...Health care costs are an increasingly important study outcome. Endoscopic pra ctice consumes a large proportion of gastroenterology- related health expenses. An economic comparison of several currently accepted endoscopic practices was p erformed, ranking them according their cost- effectiveness, as viewed from the payer perspective. The cost- effectiveness of four currently accepted standard endoscopic practices was examined: small bowel biopsy to assess for celiac sprue , colonoscopic biopsy to assess formicroscopic colitis, surveillance of Barrett’ s esophagus, and surveillance of chronic ulcerative colitis (CUC). Parameter est imates were obtained from the published literature. Charges were based on Medica re professional plus facility/technical fees. Performing colonoscopic biopsies f or microscopic colitis in the setting of chronic nonbloody diarrhea was the most cost- effective practice (＄ 2447/case detected), while small bowel biopsy for sprue in the setting of a patient with a first- degree relative with sprue (＄ 3042/case detected) or with anemia (＄ 2982/case detected) was also a cost- ef fective approach. Small bowel biopsy in the setting of diarrhea (＄ 3900/case de tected) was less cost- effective, while CUC surveillance (＄ 14,119/ detection of dysplasia) and performance of small bowel biopsy in an asymptomatic patient ( ＄ 15,209/case detected) were clearly the least economical. As efforts are made to reduce the costs of health care, more attention will be focused on the cost- effectiveness of routine endoscopic practices. Although, our findings put endos copic practices into economic perspective, future perspective, future prospectiv e trials are required to confirm the validity of these findings.展开更多
文摘Health care costs are an increasingly important study outcome. Endoscopic pra ctice consumes a large proportion of gastroenterology- related health expenses. An economic comparison of several currently accepted endoscopic practices was p erformed, ranking them according their cost- effectiveness, as viewed from the payer perspective. The cost- effectiveness of four currently accepted standard endoscopic practices was examined: small bowel biopsy to assess for celiac sprue , colonoscopic biopsy to assess formicroscopic colitis, surveillance of Barrett’ s esophagus, and surveillance of chronic ulcerative colitis (CUC). Parameter est imates were obtained from the published literature. Charges were based on Medica re professional plus facility/technical fees. Performing colonoscopic biopsies f or microscopic colitis in the setting of chronic nonbloody diarrhea was the most cost- effective practice (＄ 2447/case detected), while small bowel biopsy for sprue in the setting of a patient with a first- degree relative with sprue (＄ 3042/case detected) or with anemia (＄ 2982/case detected) was also a cost- ef fective approach. Small bowel biopsy in the setting of diarrhea (＄ 3900/case de tected) was less cost- effective, while CUC surveillance (＄ 14,119/ detection of dysplasia) and performance of small bowel biopsy in an asymptomatic patient ( ＄ 15,209/case detected) were clearly the least economical. As efforts are made to reduce the costs of health care, more attention will be focused on the cost- effectiveness of routine endoscopic practices. Although, our findings put endos copic practices into economic perspective, future perspective, future prospectiv e trials are required to confirm the validity of these findings.
