| Autor: |
Claude, Jacques, Schindler, Christian, Kuster, Gabriela M., Schwenkglenks, Matthias, Szucs, Thomas, Buser, Peter, Osswald, Stefan, Kaiser, Christoph, Grädel, Christoph, Estlinbaum, Werner, Rickenbacher, Peter, Pfisterer, Matthias |
| Zdroj: |
European Heart Journal; 2004, Vol. 25 Issue 24, p2195-2203, 9p |
| Abstrakt: |
Aim To compare benefits and costs of invasive versus medical management in elderly patients with chronic angina. Methods and results In a predefined subgroup of 188 patients of the Trial of Invasive versus Medical therapy in Elderly patients with chronic angina (TIME), one-year benefits were assessed as freedom from major events and improvements in symptoms and quality of live. Costs were determined as one-year costs of resource utilisation. Invasive patients had higher 30-day, but lower months 2–12 hospital and intervention costs than medical patients, resulting in somewhat higher one-year costs for invasive management (p=0.08). However, billing data available for a subgroup of patients showed higher practitioner's charges in the medical patients (adjusted p=0.0015). Incremental costs to prevent one major event by invasive management averaged CHF 10100 (95% CI: −800 to 28300) or € 6965, ranging from average CHF 5100 (€ 3515) to CHF 11600 (€ 8000) in a best, compared to a worst, case scenario. Conclusions Early increased costs of revascularization in invasive patients were balanced after one year by increased practitioners' charges and symptom-driven late revascularizations in medical patients. Therefore, the invasive strategy with improved clinical effectiveness at only marginally higher costs as medical management was cost-effective. Costs should not be an argument against invasive management of elderly patients with chronic angina. [ABSTRACT FROM PUBLISHER] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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