Marten J. Poley - Erasmus Universiteit Rotterdam

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24Chapter 2Table 2.1 Costs (in the Year 1998) of Units Pertaining to the Direct Medical Costs of ARMHospital days (75.8% of the total direct medical costs)Medium care € 405Intensive care € 772Day care € 322Laboratory tests * (3.8% of the total direct medical costs)12 tests: mean cost price (SD) † € 2.19 (€ 0.58)Cross-reactivity test € 5.22Blood group ABO and Rh factor € 3.24Urine culture € 16.06Postnatal chromosome culture € 499.16Diagnostic radiology and nuclear medicine (3.5% of the total direct medical costs)Echography kidneys and bladder € 79.17Echography lumbar spine € 95.11Echography heart € 85.94Abdominal X-ray (2 directions) € 39.83Lumbosacral spine (2 directions) € 42.47Voiding cystography € 106.95X-colon/videodefecography € 72.59Renography € 238.42Surgeries ‡ (16.2% of the total direct medical costs)Colostomy € 1,029Colostomy closure € 971Colostomy closure, dilatation, and electrostimulation € 1,145Posterior sagittal anorectoplasty € 3,292Anoplasty (cut back) € 624Scopy of urethra/bladder € 589Scopy of urethra/bladder, electrostimulation, and manometry € 1,024Scopy of vagina € 589Dilatation § € 24Manometry § € 143Video-urodynamic study § € 152Intercollegial consultations (0.1% of the total direct medical costs)Cardiology € 18.82Visits to the outpatient department (0.7% of the total direct medical costs)Surgery € 59.53*†‡§Tariffs instead of cost prices.Twelve different 'general' tests, such as pH, sodium, and hemoglobin.Not all combinations can be enumerated here. Rare surgical interventions and those thatresemble others are not mentioned.Outpatient. Costs of the outpatient department included.Additional echocardiography not included.
Cost-Effectiveness of Treatment for Congenital Anorectal Malformations 25Table 2.2 Direct Medical Costs of One Treatment for ARMNo. Mean Median Standard DeviationAll patients 63 € 22,082 € 18,205 € 18,225Patients with a high malformation 33 * € 29,822 € 29,504 € 13,336Patients with a low malformation 25 * € 15,654 € 8,636 € 20,493Boys 40 € 18,342 € 14,233 € 15,091Girls 23 € 28,587 € 26,797 € 21,509*The type of malformation could not be determined in 5 deceased patients.Indirect nonmedical costs. In ARM patients, there appear to be no productivitylosses caused by mortality. Patients are rarely unable to perform paid workbecause of ARM. Although reduced productivity while undertaking paid workcannot be disregarded entirely, it can be concluded that the influence of ARM inthis respect is small.We anticipated that a greater proportion of the productivity changes might fall tothe caregivers instead of the patients, but this does not seem to have been thecase despite 47% of the female caregivers and 31% of the male caregiversexpressing the view that their child needed more attention than other children ofthe same age. Table 2.5 summarizes the results.Total costs of treatment for ARM amount to € 31,593 (€ 45,660 withoutdiscounting). The discounted costs comprise direct medical costs (70%), directnonmedical costs (1%), indirect medical costs (25%), and indirect nonmedicalcosts (4%).Table 2.3 Medical Consumption of ARM Patients Compared with the General PopulationAgeARM Patients General Population0-19 yr 20-44 yr 0-19 yr 20-44 yrLast year (mean):Days of hospitalization * 0.6 † 1.5 0.4 0.5Consultations with a specialist ‡ 2.1 § 1.8 1.4 1.5Consultations with a general practitioner 2.3 3.2 3.0 4.1Consultations with a physiotherapist ‡ 1.8 1.4 1.0 2.4Consultations with an alternative healer 0.2 0.7 Unknown UnknownLast 14 days:Persons with prescribed medication (%) ** 17.7 18.7 9.0 10.2*†‡§**Admissions for childbirth are not included.Patients aged from 4 to 19 years.Consultations during hospitalization are not included.Patients aged from 2 to 19 years.Consultations by telephone are included.'Alternative' practicing GPs are not included.Contraceptive pills and medication during hospitalization are not included.
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76Chapter 5Table 5.3 Direct Medical
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80Chapter 5severely ill newborns—
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82Chapter 5REFERENCES1. Bartlett RH
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84Chapter 533. Meinert CL: Extracor
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86Chapter 568. Hui TT, Danielson PD
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88Chapter 6ABSTRACTObjective:To inv
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90Chapter 6a rule. The health-relat
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92Chapter 6Regression analysis of h
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94Chapter 6that caregiving for thei
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96Chapter 6Table 6.5 CareQol Compar
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98Chapter 6children with a disabili
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100Chapter 6This study was of impor
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102Chapter 618. Poley MJ, Stolk EA,
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104Chapter 654. Boman KK, Viksten J
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106Chapter 7ABSTRACTMortality rates
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108Chapter 77.2 THE RELEVANCE OF CO
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110Chapter 7In the early 2000s, our
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112Chapter 7Table 7.1 Economic Eval
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114Chapter 7More from a policy pers
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116Chapter 7also expect that life-s
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118Chapter 7entirely justified, for
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120Chapter 723. Sydorak RM, Nijagal
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122Chapter 765. Glaser AW, Davies K
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GENERAL DISCUSSION:A GUIDED TOURPRO
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142GlossaryCharge (or: tariff)A pri
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SUMMARY
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Summary 149mortality. Finally, it i
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Summary 151neonatal surgery. It is
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SAMENVATTING
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Samenvatting 155zoals directe niet-
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Samenvatting 159vereisen, waarvoor
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162AcknowledgmentsAlthough I am ind
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About the AuthorBorn in De Meern (N
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Marten J. Poley - Erasmus Universiteit Rotterdam

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