Cost–Effectiveness Analysis Comparison of Hysteroscopic Diagnosis with Surgery and Dilatation & Curettage for Diagnosis and Treatment of Abnormal Uterine Bleeding (AUB)
Keywords:
Abnormal Uterine Bleeding, Re-bleeding, Dilatation and curettage, Cost-effectiveness, Hysteroscopic diagnosis and resectionAbstract
A cost-effectiveness analysis of abnormal uterine bleeding (AUB) treatments in comparison of hysteroscopic diagnosis and resection and dilatation and curettage (D&C) aims to study the clinical results and assessed the cost effectiveness of abnormal uterine bleeding (AUB) treatments in comparison of hysteroscopic diagnosis and resection and dilatation and curettage (D&C) at Rajavithi Hospital. The research was conducted among Rajavithi Hospital’s patients during January 1st, 2016 to December 31st, 2016 using Decision Tree model which based on the societal perspective. The results showed that the effectiveness of treatment when followed up at 24 weeks in the group that received dilatation and curettage with no recurrent bleeding was 88.1% meanwhile another group which underwent hysteroscopic diagnosis and resection was 97.7 % (p-value = 0.11). The average cost of dilatation and curettage was higher than that of the hysteroscopic diagnosis and resection equal 329.83 baht. The incremental cost-effectiveness ratio (ICER) of dilatation and curettage compared to hysteroscopic diagnosis and resection was 3,389.83 baht per no recurrent bleeding. Therefore, the conclusion of the study was that hysteroscopic diagnosis and resection providing effectiveness in the treatment of abnormal uterine bleeding not different from D&C in terms of recurrent bleeding. Compared with D&C, hysteroscopic diagnosis and resection was better in some aspects such as more précised and specific, moreover, lower cost of treatment in societal perspective.
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