Objective: To compare the cost-effectiveness of ureteroscopy lithotripsy (UL) and laparoscopic lithotomy (LL) for treatment of 1/3 upper ureteral stones, from the view point of patients and their relatives. Methods: Retrospectively reviewing 425 hospital patient records of patient suffering from 1/3 upper ureteral stone patients who were treated by UL and LL, in Hanoi Postal Hospital, 2012- 2013. The Propensity Score Matching was applied to control the sampling error (109 pairs remained for analysing). The effectiveness of the treatments was calculated by clinical intervention outcomes after the first treatment; costs of treatment methodologies were calculated during the time of the respective treatment. Results: 100 percent of patients in the LL group were successful after the first treatment intervention, compared to 87.2 percent of UL group. Average number of inpatient days of the LL group was statistically significant difference compared to UL group (7.4 days versus 4.7 days, p.05). Average cost of one successful LL patients was 1.4 times higher than that of UL group (39.610 million VND vs 26.671 million VND). In particular, the average direct cost per patient of LL group was statistically significant diference compared to UL group (12.620 million VND vs 9.103 million VND; p .001); indirect costs of LL group 1.9 times higher than that of UL group (26.990 million VND vs 14.143 million VND; p .001). Conclusion: Treatment of 1/3 upper ureteral stones by LL methodology had a higher success rate than UL after the first treatment intervention, but the average cost from the perspective of the payer for 1 sucessfully treated patient by TNS was just 67.3 percent of the LL. The sensitivity analysis showed that UL was likely more cost - effective than the MNS. The cost - effectiveness analysis should be considered when' deciding treatments for ureteral stone patients.
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