The Clinical Efficacy And Health Economic Assessment Of The Two Treatments Of Uterine Fibroids

Objective:To investigate the clinic efficacy and health economics of laparoscopicmyomectomy(LM) and high intensity focused ultrasound (HIFU) foruterine fibroids.Methods:107cases of uterine fibroids who were admitted to our departmentfrom Jan.2011to Jan.2012(60cases in LM group and47cases in HIFUgroup) were collected, and compared clinical indicators such as hospitaldays, operation-time, intra-operative blood-lose, postoperative morbidity,the time to resumed working after operation. All the patients were asked toevaluate the efficacy on3,6,12months after treatment. Then we carried outcost-effectiveness analysis.Results:1. The patients who underwent high intensity focused ultrasoundexperienced a less blood loss and hospital days.2. Efficacy: Both treatments can improve the clinical symptoms ofuterine fibroids, but LM can improve rapidly and a lower recurrence rate compared with HIFU, whereas there is no difference between the twogroups after12months.3. The result of health economics:According to per capital real disposable income of Chongqing urbanresidents of an average of55.4yuan per day in2011. we figured out thefollowing results: the direct healthcare costs were higher in HIFU group(11404.1±1074.5vs10935.6±953.1yuan, P<0.05), while the total costswere higher in LM group(12551.7±1237.3vs12078.3±1067yuan,P<0.05).Cost-Effectiveness Analysis: In LM group for every one case ofpatient, the cost of consumption is12417.3yuan, and in the HIFU groupthe consumption cost of each one case of patient is12545.2yuan. Theconsumption cost of LM group was consumed less than the HIFU group,and recommended in this study from the perspective of health economicsprogram.Conclusions:1. Both LM and HIFU are safe and effective treatments of uterinefibroids, and HIFU is non-invasive, shorter operation time andpostoperative recovery time.2. Both treatment methods can improve the clinical symptoms ofuterine fibroids, but laparoscopic myomectomy can improve rapidly. Nodifference can be seen between the two groups after12months, and therecurrence rate of the group of HIFU is higher than the group of LM. 3. The direct healthcare costs were higher in HIFU group, the directnon-healthcare costs and indirect cost were higher in LM group. The totalcost was higher in LM group, while the LM is more cost-effective in thisstudy from the perspective of health economics.