Short and Mid-Term Economic Impact of Pulmonary Artery Catheter Use in Adult Cardiac Surgery: A Hospital and Integrated Health System Perspective.
| Autor: | Stevens M; Global Health Economics & Reimbursement, Edwards Lifesciences, Irvine, CA, USA., Davis T; Global Health Economics & Reimbursement, Edwards Lifesciences, Irvine, CA, USA., Munson SH; Department of Health Economics and Outcomes Research, Boston Strategic Partners, Inc., Boston, MA, USA., Shenoy AV; Department of Health Economics and Outcomes Research, Boston Strategic Partners, Inc., Boston, MA, USA., Gricar BLA; Department of Health Economics and Outcomes Research, Boston Strategic Partners, Inc., Boston, MA, USA., Yapici HO; Department of Health Economics and Outcomes Research, Boston Strategic Partners, Inc., Boston, MA, USA., Shaw AD; Department of Anaesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada. |
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| Jazyk: | angličtina |
| Zdroj: | ClinicoEconomics and outcomes research : CEOR [Clinicoecon Outcomes Res] 2021 Feb 05; Vol. 13, pp. 109-119. Date of Electronic Publication: 2021 Feb 05 (Print Publication: 2021). |
| DOI: | 10.2147/CEOR.S282253 |
| Abstrakt: | Objective: A monitoring pulmonary artery catheter (PAC) is utilized in approximately 34% of the US cardiac surgical procedures. Increased use of PAC has been reported to have an association with complication rates: significant decreases in new-onset heart failure (HF) and respiratory failure (RF), but increases in bacteremia and urinary tract infections. We assessed the impact of increasing PAC adoption on hospital costs among cardiac surgery patients for US-based healthcare systems. Methods: An Excel-based economic model calculated annualized savings for a US hospital with various cardiac surgical volumes and PAC adoption rates. A second model, for an integrated payer-provider health system, analyzed outcomes/costs resulting from the cardiac surgical admission and for the treatment of persistent HF and RF complications in the year following surgery. Model inputs were extracted from published literature, and one-way and probabilistic sensitivity analyses were performed. Results: For an acute care hospital with 500 procedures/year and 34% PAC adoption, annualized savings equalled $61,806 vs no PAC utilization. An increase in PAC adoption rate led to increased savings of $134,751 for 75% and $170,685 for 95% adoption. Savings ranged from $12,361 to $185,418 at volumes of 100 and 1500 procedures/year, respectively. For an integrated payer-provider health system with the base-case scenario of 3845 procedures/year and 34% PAC adoption, estimated savings were $596,637 for the combined surgical index admission and treatment for related complications over the following year. Conclusion: PAC utilization in adult cardiac surgery patients results in reduced costs for both acute care hospitals and payer-provider integrated health systems. Competing Interests: Mitali Stevens and Todd Davis report being an employee of Edwards Lifesciences, during the conduct of the study and outside the submitted work. Sibyl H Munson reports working as a consultant for Boston Strategic Partners, Inc., who received fees from Edwards Lifesciences to support this research, during the conduct of the study. Apeksha V Shenoy, Boye LA Gricar, and Halit O Yapici report being employees of Boston Strategic Partners who received payment from Edwards Lifesciences to conduct this research, during the conduct of the study. Andrew D Shaw reports personal fees from Edwards Lifesciences, outside the submitted work, and works as a consultant for Edwards Lifesciences. The authors report no other potential conflicts of interest for this work. (© 2021 Stevens et al.) |
| Databáze: | MEDLINE |
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