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Average institutional cost modeling of non-variceal gastrointestinal bleeding: Effects of the use of tranexamic acid. Calixto García General Hospital, Havana 2015

Abstract:

Introduction: The inclusion of tranexamic acid in the non variceal gastrointestinal bleeding, it is under discussion. This issue has been poorly studied from the economics point of view. Objectives: To estimate the institutional costs of the treatment of the non variceal gastrointestinal bleeding and the economic effect of the introduction of tranexamic acid in the protocol of treatment for a Cuban hospital. Method: Partial economic evalution type description of costs. Perspective of the National System of Health. It was included all cost during the stay of the patient at the institution. It was built in model based in decision tree that he considered the patient’s grade of bleeding to the arrival to the service, the services and his clinical evolution. A sensitivity analysis was made considering variations in the stay. Results: The institutional global direct cost went from 1,166.97 CUP. Results according to the grade of bleeding were: Type I 790.20 CUP; Type II 845.11 CUP; Type III 1,048.21 CUP and for the type IV 8,385.43 CUP. The departures of bigger contribution were: Complementary exams, human resources and treatment. The AT represented less than the 1 [%] of the cost. When the cost varied the stay it reached moral values among 1,054.69 CUP and 1,177.37 CUP. Conclusions: The non variceal gastrointestinal bleeding’s attention, on the average, does not represent tall expenses for the Hospital Calixto García, but in dependence of the incoming conditions of the patient it can be increased to surpass the 2 [%] of the institutional budget. The introduction of tranexamic acid does not represent an appreciable increment of the institutional cost. The non variceal gastrointestinal bleeding’s institutional cost is sensitive to the stay.