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Lasers Med Sci (2014) 29:493499 DOI 10.1007/s10103-013-1453-8
ORIGINAL ARTICLE
Socio-economic impact of endovenous thermal ablation techniques
Damian Kelleher & Tristan R. A. Lane & Ian J Franklin &
Alun H Davies
Received: 20 September 2013 /Accepted: 23 September 2013 /Published online: 5 October 2013 # Springer-Verlag London 2013
Abstract Varicose veins are common and cause extensive morbidity; however, the value of treatment is under-appreciated. Many procedures allow the treatment of varicose veins with minimal cost and extensive literature supporting differing minimally invasive approaches. In this article, we investigate the current literature regarding treatment options, clinical outcome and the cost-benefit economics associated with varicose vein treatment. The practice of defining clinical outcome with quality of life (QOL) assessment is explained to provide valid concepts of treatment success beyond occlusion rates.
Keywords QOL .QALY .Varicoseveins .Cost-effectiveness
Varicose veins are an extremely common and affect over 25 % of the population with the majority of patients presenting with varicose veins being young and otherwise systemically well [1, 2].
There are widespread misconceptions held by both the general public and primary care physicians with regards to varicose veins; the public fear that there is an increased likelihood of DVT, or that chronic venous changes are a common cause of limb amputation [3], whilst primary care physicians are often mistaken in believing that varicose veins are merely a cosmetic concern and so, leading to a reduced rate of referral for treatment, and even the skin changes of chronic venous insufficiency (a precursor to ulceration) are often deemed inconsequential [4, 5]. Additionally, knowledge
on current treatment methods in the primary care sector is
poor, leading to denial of referral for treatable patients [4, 6].
Health-care costs are spiralling; in the UK, they have doubled over the last decade to 126 billion annually [7], with a similar picture seen in the USA where spending is now $1.2 trillion/year [8], equivalent to over 8 % GDP, a value seen throughout Europe as well [9, 10].
Whilst costs and value for money have always had a role in the decision-making processes, these increasing financial pressures at the hospital, regional and national levels have caused hospital managers to look at ways to cut costs at all levels. Varicose veins have been labelled as a procedure...