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Titolo:
Cost-effectiveness of minimally invasive cardiac operations
Autore:
Ferraris, VA; Ferraris, SP;
Indirizzi:
Univ Kentucky, Albert B Chandler Med Ctr, Div Thorac & Cardiovasc Surg, Lexington, KY 40536 USA Univ Kentucky Lexington KY USA 40536 iovasc Surg, Lexington, KY 40536 USA Univ Kentucky, Albert B Chandler Med Ctr, Div Cardiothorac Surg, Lexington, KY 40536 USA Univ Kentucky Lexington KY USA 40536 thorac Surg, Lexington, KY 40536 USA Uniformed Serv Hlth Sci, Dept Surg, Bethesda, MD USA Uniformed Serv Hlth Sci Bethesda MD USA Sci, Dept Surg, Bethesda, MD USA
Titolo Testata:
HEART SURGERY FORUM
, volume: 4, anno: 2001, supplemento:, 1
pagine: S30 - S34
SICI:
1098-3511(2001)4:<S30:COMICO>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
QUALITY-OF-LIFE; BYPASS-SURGERY; CORONARY ANGIOPLASTY; CHARGES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Ferraris, VA Univ Kentucky, Albert B Chandler Med Ctr, Div Thorac & Cardiovasc Surg, Suite C-208,800 Rose St, Lexington, KY 40536 USA Univ Kentucky Suite C-208,800 Rose St Lexington KY USA 40536
Citazione:
V.A. Ferraris e S.P. Ferraris, "Cost-effectiveness of minimally invasive cardiac operations", HEART SUR F, 4, 2001, pp. S30-S34

Abstract

Background: Minimally invasive cardiac operations (MICOs) are reported to reduce procedural costs while at the same time decreasing operative morbidity and improving patient comfort. However, most of the cost data available for minimally invasive cardiac procedures is limited to short-term, peri-procedure, in-hospital costs. The scarcity of data to support claims for long-term cost-effectiveness prompted our interest in pursuing this research. Methods: Cost-effectiveness analysis was used to estimate the monetary cost required to achieve a gain in health benefit. We reviewed the literature to accumulate all available relevant cost data regarding MICO in order to apply the principles of cost-effectiveness analysis to this relatively new procedure. For purposes of the analysis, two assumptions were made: (1) MICOs have a less favorable long-term survival outcome than does conventional coronary artery bypass grafting using cardiopulmonary bypass (CABG), and (2)the reintervention rates and long-term costs resulting from MICOs are similar to those of percutaneous transluminal coronary angioplasty with intracoronary stenting (PTCA/stenting). Results: The average procedural costs from published literature were $13,782 for PTCA/stenting, $16,082 for MICO, and $23,938 for CABG. The cost-effectiveness of CABG and MICO were compared using PTCA/stenting as a standard of comparison. These estimations suggest that MICO is less cost-effective than CABG ($112,200 per year of life saved by MICO and $56,280 per year of life saved by CABG). Conclusions: Usable data to provide accurate cost-effectiveness estimates for MICO is scarce. Preliminary estimates based on available data suggest two means of improving the cost-effectiveness of MICO. First, technical advances that improve the quality of MICO (e.g., improved patency rates for mammary anastomoses and complete revascularization strategies) will decrease the reintervention rates and out-of-hospital costs. Second, application of MICO to a high-risk subset of patients who will experience improved survivalcompared to other alternatives will improve cost-effectiveness by prolonging life for those patients. Therefore, in order to be cost-effective, MICOsmust obtain high quality results, including complete revascularization, and must be used primarily in high-risk patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 12:48:24