TY - JOUR
T1 - Financial and Quality-of-Life Burden of Dysfunctional Uterine Bleeding Among Women Agreeing To Obtain Surgical Treatment
AU - Frick, Kevin D.
AU - Clark, Melissa A.
AU - Steinwachs, Donald M.
AU - Langenberg, Patricia
AU - Stovall, Dale
AU - Munro, Malcolm G.
AU - Dickersin, Kay
N1 - Funding Information:
Funded by Grant #5U01 HS09506 from the Agency for Healthcare Research and Quality to the University of Maryland (1996 to 1998) and Brown Medical School (1998–2001), and grant #5U01 HS09506 and #5HS09506a to Brown University (2001–2005).
PY - 2009/1
Y1 - 2009/1
N2 - Purpose: In this study, we sought to 1) describe elements of the financial and quality-of-life burden of dysfunctional uterine bleeding (DUB) from the perspective of women who agreed to obtain surgical treatment; 2) explore associations between DUB symptom characteristics and the financial and quality-of-life burden; 3) estimate the annual dollar value of the financial burden; and 4) estimate the most that could be spent on surgery to eliminate DUB symptoms for which medical treatment has been unsuccessful that would result in a $50,000/quality-adjusted life-year incremental cost-effectiveness ratio. Methods: We collected baseline data on DUB symptoms and aspects of the financial and quality-of-life burden for 237 women agreeing to surgery for DUB in a randomized trial comparing hysterectomy with endometrial ablation. Measures included out-of-pocket pharmaceutical expenditures, excess expenditures on pads or tampons, the value of time missed from paid work and home management activities, and health utility. We used χ2 and t tests to assess the statistical significance of associations between DUB characteristics and the financial and quality-of-life burden. The annual financial burden was estimated. Results: Pelvic pain and cramps were associated with activity limitations and tiredness was associated with a lower health utility. Excess pharmaceutical and pad and tampon costs were $333 per patient per year (95% confidence interval [CI], $263-$403). Excess paid work and home management loss costs were $2,291 per patient per year (95% CI, $1847-$2752). Effective surgical treatment costing $40,000 would be cost-effective compared with unsuccessful medical treatment. Conclusion: The financial and quality-of-life effects of DUB represent a substantial burden.
AB - Purpose: In this study, we sought to 1) describe elements of the financial and quality-of-life burden of dysfunctional uterine bleeding (DUB) from the perspective of women who agreed to obtain surgical treatment; 2) explore associations between DUB symptom characteristics and the financial and quality-of-life burden; 3) estimate the annual dollar value of the financial burden; and 4) estimate the most that could be spent on surgery to eliminate DUB symptoms for which medical treatment has been unsuccessful that would result in a $50,000/quality-adjusted life-year incremental cost-effectiveness ratio. Methods: We collected baseline data on DUB symptoms and aspects of the financial and quality-of-life burden for 237 women agreeing to surgery for DUB in a randomized trial comparing hysterectomy with endometrial ablation. Measures included out-of-pocket pharmaceutical expenditures, excess expenditures on pads or tampons, the value of time missed from paid work and home management activities, and health utility. We used χ2 and t tests to assess the statistical significance of associations between DUB characteristics and the financial and quality-of-life burden. The annual financial burden was estimated. Results: Pelvic pain and cramps were associated with activity limitations and tiredness was associated with a lower health utility. Excess pharmaceutical and pad and tampon costs were $333 per patient per year (95% confidence interval [CI], $263-$403). Excess paid work and home management loss costs were $2,291 per patient per year (95% CI, $1847-$2752). Effective surgical treatment costing $40,000 would be cost-effective compared with unsuccessful medical treatment. Conclusion: The financial and quality-of-life effects of DUB represent a substantial burden.
UR - http://www.scopus.com/inward/record.url?scp=57849147143&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57849147143&partnerID=8YFLogxK
U2 - 10.1016/j.whi.2008.07.002
DO - 10.1016/j.whi.2008.07.002
M3 - Article
C2 - 19111789
AN - SCOPUS:57849147143
SN - 1049-3867
VL - 19
SP - 70
EP - 78
JO - Women's Health Issues
JF - Women's Health Issues
IS - 1
ER -