E-alerts prove cost-effective for in-hospital VTE reduction
MedWire News: Electronic alert (e-alerts) systems are a cost effective way of reducing the incidence of venous thromboembolism (VTE) during hospitalization, particularly in medical patients, Spanish researchers report.
Despite the efficacy and safety of thromboprophylaxis in surgical and medical inpatients, several recent studies have shown an unacceptable underuse of this prevention measure in at-risk patients worldwide, remark Ramón Lecumberri (University Clinic of Navarra, Pamplona) and colleagues.
They add that computerized decision support (e-alert) systems have been shown to improve implementation of thromboprophylaxis and reduce inpatient VTE, but their cost-effectiveness is unknown.
Lecumberri and team therefore evaluated the economic impact of an e-alert system installed in a Spanish hospital to identify patients at risk for VTE. The software, implemented in 2006, was used to perform daily screening of the thrombosis risk of all in-patients. A flashing on-screen marker highlighted high-risk patients and triggered physicians to order suitable prophylaxis.
Data from all adult patients admitted to the University Clinic of Navarra during the first semesters of 2005 to 2009 (n=32,280) were included in the study.
Compared with the first semester of 2005 (pre-intervention period), the implementation of the e-alert software was associated with a 50% reduction in VTE incidence among all hospitalized patients, and a 56% reduction in medical patients, without any associated increase in major bleeding.
The researchers calculated that the mean direct cost (during hospitalization and after discharge) of an in-hospital VTE episode was €7058 (US$10,192).
When divided by the total number of patients, the direct VTE costs per single hospitalized patient were €21.60 (US$31.20) before the implementation of the e-alerts and €11.80 (US$17.00) after implementation, a saving of €9.80 (US$14.20) per patient.
The increased use of thromboprophylaxis associated with the e-alert system - from 27% to over 60% in medical patients - cost €3.00 (US$4.30) per patients, while the development of the system itself cost €0.35 (US$0.50) per patient.
Therefore, "the implementation of e-alerts led to a net cost saving of €6.55 per every hospitalized patient," write Lecumberri et al in the Journal of Thrombosis and Haemostasis.
When all hospitalized patients in Spain are considered (more than 4.5 million per year), total yearly savings would approach €30 million (US$43 million), they add.
The authors conclude: "Fewer complications and lower costs will be achieved by implementing in-hospital e-alerts."
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By Laura Dean