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[Home versus inpatient therapy for deep venous thrombosis. A cost-comparative analysis]
J Montes1, L González, L Amador
1Servicio de Medicina Interna, Hospital Meixoeiro, Complejo Hospitalario Universitario, Vigo, Pontevedra. julio.montes.santiago@sergas.es
Aims:
To compare the home-care management of deep vein thromboses (DVT) by a Home Care Unit (HCU) respect to conventional inpatient treatment.
Methods:
Twenty-one patients with a doppler-ecography diagnosis of DVT were managed by the HCU during 2002. In 7 out 13 a concomitant diagnosis of pulmonary embolism (PE) was made by lung scan. Median age was 81 years, 52% were women and all, except one case, showed severe medical concomitant conditions. All patients received low-weight molecular heparin, followed by oral anticoagulants in 3 patients. No patients died and only one was hospitalized briefly due to a poor thrombosis-related pain control. Costs of this patient were added to those of HCU. A comparison was made between ambulatory and hospitalary costs for EP and DVT. Pharmacological treatment costs were calculated for a 10-days period.
Results:
The length of inhospital stay was 1 day for HCU vs. 8 days (DVT) and 13 days (EP). There was a estimated cost-saving of 1680 per patient.
Conclusions:
The management of DVT in patients with serious conditions, can be accomplished safely and in a cost-saving manner by a Home Care Unit.
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