Co-morbidity/event |
intervention |
intervention2 |
intervention3 |
intervention4 intervention5 |
intervention6 |
UTI |
urinoculture 1 |
antibiogram 1 |
antibiotic 1 |
urinoculture 2 antibiogram 2 |
antibiotic 2 |
Urinary frequency |
urological visits |
urinoculture |
Antispasmodic |
Urine test |
|
Gyn visits |
gyn visit |
Ultrasound |
|
|
|
Vulvovaginitis |
gyn visits |
vag smear |
topical treat |
test for fungi and bacteria |
|
Gen tract symptoms |
gyn visit |
Ultrasound |
vag smear |
|
|
Cancer screening |
Pap test 1 |
Pap test 2 |
|
|
|
PM bleeding |
ER visit |
hysteroscopy |
Pap smear |
gyn visits(s) Ultrasound |
Curettage (in 80%) |
Psych. unadjustment |
counseling 1 |
counseling 2 |
counseling 3 |
counseling 4 |
|
Climacteric symptoms |
gyn visit |
ultrasound |
|
|
|
Bone & cart. Disorders |
MOC |
bone resorption inhibitors |
|
|
|
Cystocele |
intervention |
|
|
|
|
Outpatient Visits |
spec. visit |
|
|
|
|
Stress incontinence |
urol visit |
ultrasound |
urography |
|
|
Screen HPV |
visit |
colposcopy |
lab test |
|
|
Table 1: Diagnostic and therapeutic interventions after one of the 14 most frequent co-morbidities is diagnosed
E vent/co-morbidity |
cost per episode |
Urinary Tract Infections |
86.24 € |
Urinary frequency |
91.14 € |
Gynecological visits |
64.04 € |
Vulvovaginitis |
39.12 € |
Genitourinary tract symptoms |
68.50 € |
Cancer screening |
104.96 € |
Post Menopausal bleeding |
560.86 € |
Psych. unadjustment |
77.48 € |
Climacteric symptoms |
64.04 € |
Bone & Cartilage. Disorders |
211.82 € |
Cystocele |
3397.00€ |
Outpatient Visits |
20.66 € |
Stress incontinence |
142.83 € |
Screen for HPV |
95.34 € |
Table 2: Estimated cost “per occurrence” in Italy for the 14 most frequent co-morbidities and events
Co-morbidity/event |
expected difference (cases/100/yr) |
expected difference (cases/year) |
Cost per event |
Total cost of events |
Urinary Tract |
4.25 |
3264 |
86.24 € |
€ 281,520 |
Urinary frequency |
1.96 |
1505 |
91.14 € |
€ 137,207 |
Gynecological visits |
33.40 |
25654 |
64.04 € |
€ 1,642,895 |
Vulvovaginitis |
3.68 |
2827 |
39.12 € |
€ 110,575 |
Genitourinary tract symptoms |
3.38 |
2596 |
68.50 € |
€ 177,836 |
Cancer screening |
18.48 |
14194 |
104.96 € |
€ 1,489,834 |
Post Menopausal bleeding |
3.13 |
2404 |
560.86 € |
€ 1,348,376 |
Psych. Unadjustment |
10.00 |
7681 |
77.48 € |
€ 595,116 |
Climacteric symptoms |
6.97 |
5354 |
64.04 € |
€ 342,844 |
Bone & Carilaget. Disorders |
3.64 |
2796 |
211.82 € |
€ 592,216 |
Cystocele |
1.81 |
1390 |
3397.00 € |
€ 4,722,655 |
Outpatient Visits |
2.53 |
1943 |
20.66 € |
€ 40,148 |
Stress incontinence |
1.98 |
1521 |
142.03 € |
€ 216,002 |
Dysuria |
1.51 |
1160 |
35.48 € |
€ 41,150 |
Osteoporosis |
3.39 |
2604 |
211.82 € |
€ 551,542 |
Leukorrhea |
1.30 |
999 |
39.12 € |
€ 39,062 |
Ovary Cysts |
0.99 |
760 |
64.04 € |
€ 48,697 |
Cervicitis |
0.95 |
730 |
31.40 € |
€ 22,912 |
Hematuria |
1.74 |
1336 |
31.14 € |
€ 41,618 |
Screen for HPV |
3.20 |
2458 |
95.34 € |
€ 234,335 |
|
|
|
Total cost |
€ 12,676,541 |
Table 3: Total cost per year to the NHS of co-morbidities in BCS/VVA patients
Tables at a glance