Kostnader og rekonvalesens ved behandling for venøs insuffisiens - en sammenlikende observasjonsstudie mellom endovenøs steambehandling og stripping av vena safena magna
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Background: Endovenous Steam Ablation (Steam) of Vena Saphena Magna (VSM), due to venous insufficiency, is a new treatment believed to reduce time of convalescence compared with High Ligation and Stripping (Stripping). However, new treatment methods often increases costs due to the price of new equipment. Purpose: The purpose of this master thesis is to compare differences in convalescence and treatment costs between Steam and Stripping, and to our knowledge this has not previous been done. Material and Methods: Eighty tree patients previously assigned to outpatient steam ablation (46) or day-surgery stripping (37) was included. Stripping vs. Steam respectively: Age 51.5 vs. 53.7 years. Female 67.6 % vs. 71.7 %. Classification C2 (varices) 51.4 % vs. 56.5 %. Working 78.4 % vs. 65.2 %. Patients were contacted every second week until they resumed all expected activities such as daily activities, training/ sport and work and no longer had limitations in daily life. We used a micro-costing approach to calculate costs including staff salary, disposable and reusable equipment, cleaning, room, medication and food. We used mean procedure and operation room times as units and assumed equal treatment effects when comparing costs and outcomes. Results: Steam vs. stripping patients resumed daily activities after median (IQR) 0 (0-2) vs. 4 (1,5-6,5) days, training/ sport after 4 (2-9) vs. 11 (3-19) days and had limitations in daily life for 2 (0-3,3) vs. 10 (3,5-15,5) days, and had 2 (0-5) vs. 14 (6-21) days with sick leave. Stripping and steam costed respectively NOK 10 109 and NOK 5 972, which made steam NOK 4 137 less expensive. Conclusion: Steam patients recovered faster than patients receiving stripping did. Our results indicate that steam ablation can be offered at a lower cost, and with shorter convalescence than stripping. This indicate that steam may be cost effective compared to stripping. Relevance: The convalescence results in this study can be used to inform patients what to expect when seeking one of the two treatment strategies for venous insufficiency. The cost results is a relevant information for hospitals and departments that are treating patients with steam ablation or stripping with high ligation. Departments that want to calculate their own treatment costs can replace our results with their own due to our detailed description.