Cost during and after menorrhagia surgery
We compared the economic impact during and after the surgical management
of menorrhagia between strategies over time, by tracking all
re-hospitalizations. To do this, we calculated, for each patient, the
total cost of hospitalizations, by linking all stays that occurred from
the surgery and during a given period of time. For the base-case
analysis, the time horizon was fixed at 18 months, as all the included
patients had at least 18 months of follow-up, meaning that the total
cost can be considered as complete during the period (no cost
censoring). Sensitivity analyses were performed with a horizon time of
60 months, only for patients having a follow-up at least equal to 60
months.
Costs were restricted to hospital costs and were determined from the
French social security perspective. Hospital costs were calculated using
the national DRG tariffs for each year considered, and were expressed in
2017 Euros. Tariffs included nursing care, treatments, drugs, food and
accommodation, and investment costs. For public hospitals, tariffs also
covered medical and technical procedures. For private hospitals, costs
were estimated using the official DRG tariffs for private hospitals to
which physician’s fees were added (as they are not included in DRG
tariffs and are reimbursed on a fee-for-service basis). Whatever the
sector, costs also included additional cost per day of hospitalisation
in an intensive care unit, if needed. Medications and devices prescribed
or delivered during outpatient visits were not considered, as well as
ambulatory costs and indirect costs related to productivity loss. Costs
are presented as mean cost per patient per strategy.