38457
document
Financial and quality-of-life burden of dysfunctional uterine bleeding among women agreeing to obtain surgical treatment . 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 chi2 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 .
38458
Intervention_Educational
Financial and quality-of-life burden
38459
Intervention_Other
financial and quality-of-life burden
38460
Intervention_Other
financial and quality-of-life burden
38461
Intervention_Educational
baseline data on DUB symptoms and aspects of the financial and quality-of-life burden
38462
Intervention_Other
financial and quality-of-life burden
38463
Intervention_Other
financial and quality-of-life effects
38464
Outcome_Other
out-of-pocket pharmaceutical expenditures
38465
Outcome_Other
excess expenditures on pads or tampons
38466
Outcome_Other
the value of time missed from paid work and home management activities
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Outcome_Other
health utility
38468
Outcome_Pain
Pelvic pain and cramps
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Outcome_Pain
activity limitations
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Outcome_Physical
tiredness
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Outcome_Other
lower health utility
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Outcome_Other
Excess pharmaceutical and pad and tampon costs
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Outcome_Other
paid work and home management loss costs
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Outcome_Other
Effective surgical treatment
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Outcome_Other
cost-effective
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Participant_Condition
dysfunctional uterine bleeding among women agreeing to obtain surgical treatment .