Hospitalization for pelvic inflammatory disease: a cost-effectiveness analysis.

摘要

OBJECTIVE: Nulliparous women are frequently hospitalized for treatment of pelvic inflammatory disease (PID). GOAL: The goal of this study was to determine the economic feasibility of hospitalizing adolescents and young women for PID. STUDY DESIGN: The authors conducted a Markov decision model, estimating the cost-effectiveness of hospitalization compared with outpatient therapy for mild to moderate PID for adolescents and young women, calculating costs per quality-adjusted life-year (QALY) gained under various assumptions about hospitalization effects on complications. RESULTS: If hospitalization decreases PID complications by 10%, 20%, or 30%, the cost/QALY gained is 145,000 dollars, 67,400 dollars, or 42,400 dollars, respectively, compared with outpatient therapy. Assumptions about hospitalization effects on the development of chronic pelvic pain heavily weight the analysis; costs/QALY gained by hospitalization increase considerably if chronic pain is unaffected. CONCLUSION: Hospitalization for PID treatment to possibly preserve fertility in nulliparous young women and adolescents is unlikely to be economically reasonable even if substantial improvements in PID complication rates are assumed.