Comparative econometric cost analysis of inpatient versus outpatient laser treatment for twin-twin transfusion syndrome
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: To compare the costs of inpatient versus outpatient laser ablation of placental vessels treatment of severe twin-twin transfusion syndrome. To evaluate if outpatient is non-inferior to inpatient treatment with regards to feasibility and safety. Methods: Case-control study of 71 pregnant women who underwent laser ablation of placental vessels for treatment of severe twin-twin transfusion syndrome between 2019 and 2022. To compare the costs of outpatient versus inpatient treatments we used conditional estimation of the average costs of each procedure and the differences between them with paired data estimators: multivariate distance matching and propensity score matching. Comparisons of surgical and clinical variables were performed using the Chi-square or Fisher's exact tests and Student's t-test. Results: Laser ablation of placental vessels was performed in 71 patients with severe twin-twin transfusion syndrome. Sixteen (16/71 - 23%) patients were operated on in the outpatient clinic and 55 (55/71 - 77%) were operated on as inpatients. The cost of inpatient intervention was 28% and 29% higher than the cost of the outpatient treatment, according to the multivariate distance matching and propensity score matching estimates, respectively. Apart from ex-recipient intrauterine death (greater in the outpatient group), there were no significant differences between the two groups regarding laser ablation of placental vessels, post laser treatment, perinatal variables and variables from delivery until hospital discharge. Conclusion: Laser ablation of placental vessels to treat severe twin-twin transfusion syndrome in an outpatient setting is significantly cheaper than in inpatients, without any compromise in feasibility and safety, as most fetal, neonatal and maternal results were similar.
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204181289