RT Journal Article
SR Electronic
T1 The financial costs to patients of diagnosing and excluding ectopic pregnancy
JF Journal of Family Planning and Reproductive Health Care
JO J Fam Plann Reprod Health Care
FD British Medical Journal Publishing Group
SP 197
OP 200
DO 10.1136/jfprhc-2012-100368
VO 39
IS 3
A1 Holger W Unger
A1 Lisa Starrs
A1 Linda Scott
A1 Hilary O D Critchley
A1 W Colin Duncan
A1 Andrew W Horne
YR 2013
UL http://jfprhc.bmj.com/content/39/3/197.abstract
AB Objectives Health care costs are one of the greatest challenges in modern medicine. In gynaecology, diagnosing and excluding ectopic pregnancy (EP) has been shown to be a financial burden to health services because it commonly requires multiple investigations and hospital visits. However, the full economic costs are not captured by an analysis of health care costs alone. This study therefore aimed to assess the indirect costs to patients of diagnosing and excluding EP. Methods Patients presenting to a Pregnancy Support Centre in a large UK teaching hospital with abdominal pain and/or bleeding and a positive pregnancy test were recruited during the period June 2010–February 2011. Patients were provided with questionnaires to be completed at home and designed to record and quantify costs that they had incurred until a final diagnosis of their condition was made. A cost–description analysis was performed. Results 52/203 (26%) recruited patients returned completed questionnaires. The mean cost to patients of diagnosing or excluding EP was £135.13±£51.60 (median £20.70). The main cost drivers identified were hospital visits, holiday cancellations, income loss and household help. Conclusions Quantification of the indirect costs of diagnosing and excluding EP is challenging because it relies on questionnaire feedback from patients at a time when they have suffered from the emotional impact of pregnancy loss. However, initial estimates suggest that such costs are significant due to diagnostic delays. This further highlights the importance of the development of potential biomarkers of EP to allow prompt diagnosis.