| Autor: |
Zenger, Brian, Li, Haojia, Bunch, T. J, Crawford, Candice, Fang, James C, Hess, Rachel, Maires, Chase, Ranjan, Ravi, Zhang, Yue, Steinberg, Benjamin A |
| Zdroj: |
Circulation (Ovid); November 2021, Vol. 144 Issue: Supplement 1 pA8922-A8922, 1p |
| Abstrakt: |
Background:AF ablation approaches and outcomes vary. Very little work has been done to assess the variability of ablation costs to health systems and drivers of variability.Objective:Determine the drivers of cost variability in AF ablation procedures.Methods:We assessed the costs of AF ablation procedures performed between 2013-2020 at a single tertiary care center. Cost to the health system were inflation-adjusted and separated into facility, imaging, implant, pharmacy, supply, labs, and other services. Only patients who were outpatient and had an ablation by an operator who performed >10 procedures were included. Lasso multivariable regression was used to identify the primary drivers of variability in costs, including operator and patient characteristics.Results:1072 patients with 1284 AF ablations were included (age: 65.1, SD: 11.0; men: 68%; CHADS2-Vasc: 2.8, SD: 1.9, beta blockers: 63%, non-white race: 6%). Procedures were performed by 8 operators. Proportional contributions to overall costs are shown in the Figure. Regression analysis demonstrated higher average cost for men, (1.25%), non-white race (2.6%), beta-blocker use (1.9%), prior ablation (0.98%), anticoagulation use (1.4%), and operator (highest operator cost increase vs. lowest, 18%). There was no relation to CHADS2-Vasc or age. Cost variability was primarily driven by supplies including catheters and other equipment.Conclusion:Cost variability was only modestly related to patient characteristics. The largest contributor to cost in AF ablations was supplies, which are primarily operator dependent. |
| Databáze: |
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