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THE HARMONIC STUDY: COST-EFFECTIVENESS EVALUATION OF THE USE OF THE ULTRASONIC SCALPEL IN TOTAL THYROIDECTOMY

Published online by Cambridge University Press:  14 September 2012

Matteo Ruggeri
Affiliation:
Università Cattolica del Sacro Cuore email: mruggeri@rm.unicatt.it
Rossella Dibidino
Affiliation:
Università Cattolica del Sacro Cuore
Marco Marchetti
Affiliation:
Università Cattolica del Sacro Cuore
Celestino Pio Lombardi
Affiliation:
Università Cattolica del Sacro Cuore
Marco Raffaelli
Affiliation:
Università Cattolica del Sacro Cuore
Americo Cicchetti
Affiliation:
Università Cattolica del Sacro Cuore

Abstract

Background: Total thyroidectomy (TT) can be performed either with the traditional technique or using the ultrasound scalpel. Here, the use of the ultrasound scalpel is investigated in order to assess cost-effectiveness from an hospital, third party payer and societal perspective.

Methods: A randomized controlled trial was conducted at the University Hospital A. Gemelli in Rome. Data refer to 198 patients, randomized to either surgery with the ultrasound scalpel (n = 96) or traditional (n = 102) and followed for 3 months after hospital discharge. Operation time (OT) and resource consumption were recorded. Main clinical outcome investigated was quality of life (evaluated with EQ-5D).

Results: A shorter operation time (traditional: 76.36 vs ultrasound: 54.16 minutes, p < 0.001) was observed. 3 months after surgery, differences in QoL were significant (0.91 vs 0.84, p = 0.002). Concerning the hospital perspective, ultrasound scalpel allows savings of 119 EUR per patient. From a societal perspective, ultrasound scalpel is also related to lower medical resource consumption during a 3 month follow-up after discharge (traditional: 129.03 EUR vs ultrasound: 107.82 EUR) and lower non-medical resource utilization (transport/hotels costs traditional:535.51 EUR vs ultrasound: 342.77 EUR. No statistical difference was found in productivity losses up to 3 months (traditional: 377.71 EUR vs ultrasound: 385.51 EUR).

Conclusion: Allowing an overall saving of 325.36 EUR per patient, Ultrasound scalpel should be adopted for TT procedures in the “A.Gemelli” University hospital.

Type
ASSESSMENTS
Copyright
Copyright © Cambridge University Press 2012

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