Marten J. Poley - Erasmus Universiteit Rotterdam

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76Chapter 5Table 5.3 Direct Medical Costs for ECMO and Control PatientsCDH MAS TotalECMO patients n = 23 n = 31 n = 54Variable costs Medical supplies € 2,642 € 1,396 € 1,927Diagnostics € 11,292 € 7,585 € 9,164Medications € 5,540 € 2,324 € 3,694Interventions € 1,595 € 165 € 774ECMO * € 7,454 € 5,154 € 6,134Various € 128 € 62 € 90Costs of personnel € 14,139 € 7,845 € 10,525Fixed costs € 8,002 € 4,940 € 6,244Total costs € 50,792 € 29,472 € 38,553Control patients n = 24 n = 21 n = 45Costs of stay on IC First day € 855 € 669 € 768Subsequent days € 4,494 € 9,542 € 6,850Costs of stay on MC € 2,002 € 1,342 € 1,694Diagnostics € 5,179 € 9,515 € 7,203Interventions € 736 € 841 € 785Total costs € 13,267 € 21,909 € 17,300*All variables expressed by means. Abbreviations: IC, intensive care; MC, medium care.This category involves resource use directly related to ECMO: costs of thecannulation/decannulation procedures, costs of priming the ECMO circuit, costs of the ECMOpack, costs of the ECMO run, device costs, and costs of Astrup and ACT (activated clottingtime) tests.Direct medical costs for treatment of patients in the control group werecomparatively low with an average of € 17,300 (Table 5.3).Thus, the difference in costs was calculated at an average of € 21,253. For a part,this difference is due to the enhanced survival rates, which results in longerhospital stays.EffectsDuring the study period, 57 of all 244 ECMO patients (23%) deceased, with amean life span of 28 days (median, 18 days). Of all 46 control patients, 34 (74%)had died (mean life span, 4 days; median, 2 days). In this study's follow-up, nopatients were found that died after their first year of life. For CDH patients, thesurvival rate was 0.04 without ECMO and 0.52 with ECMO, as seen in Figure 5.1.For MAS patients, survival without ECMO was 0.50, as compared to 0.94 in theECMO era (Figure 5.2). Regarding the CDH patients, the relative risk of death ofECMO patients compared to the control group was 0.50 (95% confidence interval,0.40 to 0.62). For the patients with MAS, the relative risk of death amounted to0.13 (95% confidence interval, 0.06 to 0.27).
Cost-Effectiveness of Neonatal Extracorporeal Membrane Oxygenation in the Netherlands 77Figure 5.1 Kaplan-Meier Curves of the CDH PatientsAs also in Figure 5.2, the stepped lines represent the cumulative survival probability. Thecumulative survival drops each time a death occurs. After the last death, the curve remains flatuntil the longest censored survival time.Figure 5.2 Kaplan-Meier Curves of the MAS Patients
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COST-EFFECTIVENESS OF NEONATAL SURG
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DOCTORAL COMMITTEEPromotors:Prof.dr
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PUBLICATIONSChapters 2 to 7 are bas
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6ChapterINFORMAL CARE FOR CHILDREN
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2Chapter 11.1 BACKGROUND AND MOTIVA
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4Chapter 1provides a good overview
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6Chapter 1disability, and death of
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Introduction 9particular equity pri
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Introduction 1320. Oostenbrink JB,
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Introduction 1554. Heyman MB, Harma
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THE COST-EFFECTIVENESS OFTREATMENT
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Cost-Effectiveness of Treatment for
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Cost-Effectiveness of Treatment for
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Page 54 and 55: 42Chapter 3diaphragm was closed (Ta
Page 56 and 57: 44Chapter 3Total costs of treatment
Page 58 and 59: 46Chapter 3Regarding the treatment
Page 60 and 61: 48Chapter 3REFERENCES1. Stolk EA, P
Page 62 and 63: 50Chapter 332. Jaillard S, Pierrat
Page 64 and 65: 52Chapter 4ABSTRACTAims:To examine
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Page 68 and 69: 56Chapter 4Clearly, the symptoms st
Page 70 and 71: 58Chapter 4The respondents did not
Page 72 and 73: 60Chapter 4Table 4.4TAIQOL Scores o
Page 74 and 75: 62Chapter 44.4 DISCUSSIONIn this pa
Page 76 and 77: 64Chapter 4ACKNOWLEDGMENTSWe are in
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Page 80 and 81: 68Chapter 5ABSTRACTObjective:Extrac
Page 82 and 83: 70Chapter 5treatment. 26,27 Finally
Page 84 and 85: 72Chapter 5CostsOnly direct costs w
Page 86 and 87: 74Chapter 5summarized in Table 5.2.
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Page 94 and 95: 82Chapter 5REFERENCES1. Bartlett RH
Page 96 and 97: 84Chapter 533. Meinert CL: Extracor
Page 98 and 99: 86Chapter 568. Hui TT, Danielson PD
Page 100 and 101: 88Chapter 6ABSTRACTObjective:To inv
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Page 106 and 107: 94Chapter 6that caregiving for thei
Page 108 and 109: 96Chapter 6Table 6.5 CareQol Compar
Page 110 and 111: 98Chapter 6children with a disabili
Page 112 and 113: 100Chapter 6This study was of impor
Page 114 and 115: 102Chapter 618. Poley MJ, Stolk EA,
Page 116 and 117: 104Chapter 654. Boman KK, Viksten J
Page 118 and 119: 106Chapter 7ABSTRACTMortality rates
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Page 124 and 125: 112Chapter 7Table 7.1 Economic Eval
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Page 130 and 131: 118Chapter 7entirely justified, for
Page 132 and 133: 120Chapter 723. Sydorak RM, Nijagal
Page 134 and 135: 122Chapter 765. Glaser AW, Davies K
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General Discussion: A Guided Tour P
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142GlossaryCharge (or: tariff)A pri
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144Glossaryefficient one. We are th
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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 157Hoofdstuk 6 gaat ve
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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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