Abstract
The clinical effectiveness of the preoperative urinalysis is unproven, yet it is routinely obtained before surgery. To determine if the routine urinalysis might be economically beneficial, we evaluated its cost-effectiveness and cost-benefit. In the setting of elective clean-wound, non-prosthetic knee procedures, we estimated that: (1) nearly U.S. $7,000,000 is spent annually on preoperative urinalyses and associated costs; (2) given the best estimate of the increase in risk of wound infection attributable to urinary tract infection, 4.58 wound infections may be prevented annually, at a cost of $1,500,000 per wound infection prevented; (3) the cost of treating additional cases of wound infection, given no preoperative urinalysis, is approximately five hundred-fold less than the cost of screening with routine urinalyses. We conclude that the routine preoperative urinalysis is clinically and economically unsound before clean-wound, non-prosthetic knee surgery and probably before other types of clean-wound surgery. For this relatively inexpensive test, aggregate costs are disproportionately high and appear to outweigh clinical benefits.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1185-1192 |
| Number of pages | 8 |
| Journal | Journal of Clinical Epidemiology |
| Volume | 42 |
| Issue number | 12 |
| DOIs | |
| State | Published - 1989 |
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Keywords
- Cost-benefit
- Preoperative screening
- Urinalysis
- Urinary tract infection
- Wound infection Cost-effectiveness
ASJC Scopus subject areas
- Medicine(all)
- Epidemiology
- Public Health, Environmental and Occupational Health
Cite this
The unproven utility of the preoperative urinalysis : Economic evaluation. / Lawrence, V. A.; Gafni, A.; Gross, M.
In: Journal of Clinical Epidemiology, Vol. 42, No. 12, 1989, p. 1185-1192.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The unproven utility of the preoperative urinalysis
T2 - Economic evaluation
AU - Lawrence, V. A.
AU - Gafni, A.
AU - Gross, M.
PY - 1989
Y1 - 1989
N2 - The clinical effectiveness of the preoperative urinalysis is unproven, yet it is routinely obtained before surgery. To determine if the routine urinalysis might be economically beneficial, we evaluated its cost-effectiveness and cost-benefit. In the setting of elective clean-wound, non-prosthetic knee procedures, we estimated that: (1) nearly U.S. $7,000,000 is spent annually on preoperative urinalyses and associated costs; (2) given the best estimate of the increase in risk of wound infection attributable to urinary tract infection, 4.58 wound infections may be prevented annually, at a cost of $1,500,000 per wound infection prevented; (3) the cost of treating additional cases of wound infection, given no preoperative urinalysis, is approximately five hundred-fold less than the cost of screening with routine urinalyses. We conclude that the routine preoperative urinalysis is clinically and economically unsound before clean-wound, non-prosthetic knee surgery and probably before other types of clean-wound surgery. For this relatively inexpensive test, aggregate costs are disproportionately high and appear to outweigh clinical benefits.
AB - The clinical effectiveness of the preoperative urinalysis is unproven, yet it is routinely obtained before surgery. To determine if the routine urinalysis might be economically beneficial, we evaluated its cost-effectiveness and cost-benefit. In the setting of elective clean-wound, non-prosthetic knee procedures, we estimated that: (1) nearly U.S. $7,000,000 is spent annually on preoperative urinalyses and associated costs; (2) given the best estimate of the increase in risk of wound infection attributable to urinary tract infection, 4.58 wound infections may be prevented annually, at a cost of $1,500,000 per wound infection prevented; (3) the cost of treating additional cases of wound infection, given no preoperative urinalysis, is approximately five hundred-fold less than the cost of screening with routine urinalyses. We conclude that the routine preoperative urinalysis is clinically and economically unsound before clean-wound, non-prosthetic knee surgery and probably before other types of clean-wound surgery. For this relatively inexpensive test, aggregate costs are disproportionately high and appear to outweigh clinical benefits.
KW - Cost-benefit
KW - Preoperative screening
KW - Urinalysis
KW - Urinary tract infection
KW - Wound infection Cost-effectiveness
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UR - http://www.scopus.com/inward/citedby.url?scp=0024810918&partnerID=8YFLogxK
U2 - 10.1016/0895-4356(89)90117-0
DO - 10.1016/0895-4356(89)90117-0
M3 - Article
C2 - 2511275
AN - SCOPUS:0024810918
VL - 42
SP - 1185
EP - 1192
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
SN - 0895-4356
IS - 12
ER -