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.