# Outpatient treatment of varicose veins with endolaser in clinic vs. hospital: cost-benefit and safety assessment

## TL;DR

This study compares the safety and cost of outpatient versus hospital-based laser treatment for varicose veins, finding outpatient treatment is safe and cost-effective despite higher clinic fees.

## Contribution

Demonstrates the safety and cost-benefit of outpatient endolaser treatment for varicose veins in Brazil.

## Key findings

- Outpatient treatment had a statistically higher cost (R$1593.40) compared to hospital treatment (R$1391.99).
- No intraoperative or postoperative complications were observed in either group.
- Outpatient treatment is safe and offers positive cost-benefit for patients despite higher costs.

## Abstract

Varicose disease is a common pathology among the population, with an incidence of about 38%. In Brazil, it affects 45% of women and 30% of men. Currently, endovenous thermal ablation (EVTA) of the saphenous vein is the method of choice in the treatment of varicose veins. As a minimally invasive procedure that promotes quick recovery and does not require hospitalization, it can be performed on an outpatient basis.

To evaluate the safety and cost-benefit of outpatient varicose vein treatment in a clinic compared to the same procedure performed in a hospital environment.

A uncontrolled retrospective transversal study of case series evaluated a random group of 50 patients undergoing EVTA for the treatment of varicose disease by the same group of vascular surgeons. Twenty-five underwent the procedure in a tertiary hospital environment and 25 on an outpatient basis. The average costs of room fees and materials from both groups were analyzed and statistically compared with the Student's t-test. Intraoperative and postoperative complications were assessed.

The average hospital cost of the procedure was R$ 1391.99 (± 280.8) in the hospital and R$ 1593.40 (± 99.53) in the clinic. The Student's t-test showed a significant difference with p=0.02. No patient had complications either intraoperatively or postoperatively.

Outpatient surgery, despite having a statistically higher cost than hospital surgery in Brazil, is safe and has a positive cost-benefit for the patient.

A doença varicosa é comum entre a população, com incidência de cerca de 38%. No Brasil, ela atinge 45% das mulheres e 30% dos homens. Atualmente, a termoablação endovenosa (TAEV) de safenas é o método de escolha no tratamento de varizes. Por ser um procedimento minimamente invasivo, que promove rápida recuperação e não exige internação hospitalar, ele pode ser realizado a nível ambulatorial.

Avaliar a segurança e o custo-benefício do tratamento ambulatorial de varizes em clínica, comparando ao mesmo procedimento realizado em ambiente hospitalar.

Estudo transversal, retrospectivo e não controlado, do tipo série de casos, que avaliou um grupo aleatório de 50 pacientes submetidos à TAEV para tratamento de doença varicosa, realizado por um mesmo grupo de cirurgiões vasculares. Entre os pacientes, 25 realizaram o tratamento em hospital terciário e 25 ambulatorialmente. As médias dos custos de taxa de sala e de materiais dos dois grupos foram analisadas e comparadas estatisticamente com o teste t de Student. Complicações intra e pós-operatórias foram avaliadas.

A média do custo hospitalar do procedimento foi de R$ 1.391,99 (± 280,8) no hospital e de R$ 1.593,40 (± 99,53) na clínica. O teste t de Student apresentou diferença significativa, com p = 0,02. Nenhum paciente teve complicações intra ou pós-operatórias.

A cirurgia ambulatorial, apesar de ter um custo estatisticamente maior que a hospitalar no Brasil, é segura e tem custo-benefício positivo para o paciente.