[Cost-effectiveness study of the diagnosis of pleural effusion in chest diseases outpatient clinic]

Abstract

Objective: To evaluate the diagnostic efficacy of pleural procedures, safety, delay and cost of the diagnosis of pleural effusion (PE) by analysing the parameters that are dependent on the area of patient management (outpatient or inpatient).

Patients and methods: Prospective non-randomized study. Two groups were established depending on whether they were managed in a specific outpatient unit or as a conventional hospital inpatient, with the rest of the criteria being the same for the study of the PE.

Results: We included 60 outpatients and 34 inpatients. The median number of visits as an outpatient was 2 (range 2-3), and the time an inpatient was hospitalized was 13 (range 7.7-25-2) days. The number of analytical and imaging studies was significantly higher in the inpatient group. There were no differences in the number of cytology and pleural biopsies, or complications between groups. There were no differences in time to performing computed tomography. The number of days until the pleural biopsy and the time until to obtain a diagnosis was lower in the outpatient group. Mean total cost for an outpatient was euro1.352 and euro9.793,2 for inpatients.

Conclusions: Management of ambulatory diagnosis of PE patients is highly cost-effective. The effectiveness and safety of forms of the study is at least similar. In this study, the mean cost for a hospitalised inpatient for a PE was 7.2 times higher than outpatient management.