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Direct medical cost of pelvic inflammatory disease and its sequelae:
decreasing, but still substantial.
Obstetrics & Gynecology 2000;95(3):397-402.
Rein DB, Kassler WJ, Irwin KL, Rabiee L.
Abstract
OBJECTIVE: To estimate direct medical costs and average lifetime cost per case
of pelvic inflammatory disease (PID). METHODS: We estimated the direct medical
expenditures for PID and its three major sequelae (chronic pelvic pain, ectopic
pregnancy, and infertility) and determined the average lifetime cost of a
case of PID and its sequelae. We analyzed 3 years of claims data of privately
insured individuals to determine costs, and 3 years of national survey data
to determine number of cases of PID, chronic pelvic pain, and ectopic pregnancy.
We developed a probability model to determine the average lifetime cost of
a case of PID. RESULTS: Direct medical expenditures for PID and its sequelae
were estimated at $1.88 billion in 1998: $1.06 billion for PID, $166 million
for chronic pelvic pain, $295 million for ectopic pregnancy, and $360 million
for infertility associated with PID. The expected lifetime cost of a case
of PID was $1167 in 1998 dollars. The majority of those costs ($843 per case)
represent care for acute PID rather than diagnosis and treatment of sequelae.
Approximately 73% of cases will not accrue costs beyond the treatment of
acute PID. CONCLUSION: The direct medical cost of PID is still substantial.
The majority of PID related costs are incurred in the treatment of acute
PID. Because most PID-related costs arise in the first year from treatment
of acute PID infection, strategies that prevent PID are likely to be cost-effective
within a single year.