PMID- 35979033
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220819
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 10
IP  - 8
DP  - 2022 Aug
TI  - Impact of endoscopic ultrasound-guided gallbladder drainage on reducing costs of 
      reintervention and unplanned readmission: a budget impact analysis.
PG  - E1073-E1079
LID - 10.1055/a-1819-8124 [doi]
AB  - Background and study aims  Endoscopic ultrasound-guided gallbladder drainage 
      (EUS-GBD) is the preferred treatment for patients with acute calculous 
      cholecystitis who are unfit for surgery. The aim of this study was to perform a 
      cost-effective analysis (CEA) comparing EUS-GBD with percutaneous gallbladder 
      drainage (PT-GBD). Patients and methods  CEA was performed on patients recruited 
      for our prior randomized controlled trial. A budget impact model was developed to 
      compare the base-case and scenario of EUS-GBD applications. The costs including 
      peri-procedure and intra-procedure, reinterventions, expenses associated with 
      treatment of adverse events (AEs), costs of hospital stay, subsequent clinic 
      follow-up, and unplanned readmission were included. Results  PT-GBD had a lower 
      total procedure cost per patient (USD$4,375.00) than EUS-GBD (USD$9,397.44). For 
      EUS-GBD, the cost of cautery-enhanced lumen-apposing stent accounted for the 
      major part of the expense (USD$4,910.26). EUS-GBD resulted in a lower expected 
      cost (USD$108.26 vs USD$1,601.54) for a re-procedure. The expected cost per 
      patient in unplanned readmissions in the EUS-GBD group (USD$450.00) was lower 
      than that in the PT-GBD group (USD$1,717.56). Based on the budget impact 
      analysis, the net budget impact per year of introducing EUS-GBD to replace PT-GBD 
      was higher (USD$16,424.10 vs USD$11,433.08). The net budget impact was most 
      sensitive to the cost of stent and linear echoendoscope used in EUS-GBD. 
      Conclusions  The net budget impact per year was higher for introducing EUS-GBD. 
      The cost of the stent accounted for the major cost difference between the two 
      procedures. EUS-GBD saved on the cost in management of AEs, reinterventions, and 
      unplanned readmissions but these did not offset the cost of the stent.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Chan, Shannon Melissa
AU  - Chan SM
AD  - Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong 
      Kong, Shatin, Hong Kong, China.
FAU - Chong, Marc Ka Chun
AU  - Chong MKC
AD  - Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 
      Chinese University of Hong Kong, Hong Kong, China.
FAU - Chiu, Philip Wai Yan
AU  - Chiu PWY
AD  - Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong 
      Kong, Shatin, Hong Kong, China.
FAU - Ng, Enders Kwok Wai
AU  - Ng EKW
AD  - Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong 
      Kong, Shatin, Hong Kong, China.
FAU - Wong, Martin Chi Sang
AU  - Wong MCS
AD  - Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 
      Chinese University of Hong Kong, Hong Kong, China.
FAU - Teoh, Anthony Yuen Bun
AU  - Teoh AYB
AD  - Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong 
      Kong, Shatin, Hong Kong, China.
LA  - eng
PT  - Journal Article
DEP - 20220815
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC9377823
COIS- Competing interests Prof. Teoh is a consultant for Boston Scientific, Cook, 
      Taewoong, and Microtech Medical Corporations.
EDAT- 2022/08/19 06:00
MHDA- 2022/08/19 06:01
PMCR- 2022/08/01
CRDT- 2022/08/18 02:10
PHST- 2021/11/24 00:00 [received]
PHST- 2022/04/06 00:00 [accepted]
PHST- 2022/08/18 02:10 [entrez]
PHST- 2022/08/19 06:00 [pubmed]
PHST- 2022/08/19 06:01 [medline]
PHST- 2022/08/01 00:00 [pmc-release]
AID - 10.1055/a-1819-8124 [doi]
PST - epublish
SO  - Endosc Int Open. 2022 Aug 15;10(8):E1073-E1079. doi: 10.1055/a-1819-8124. 
      eCollection 2022 Aug.