Cost Analysis of Minimally Invasive Mitral Valve Surgery in the UK National Health Service
| Autor: | Kenneth Palmer, Matthew Shaw, Giordano Perin, Caroline Toolan, Omar Al-Rawi, Paul Modi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Heart Valve Diseases 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Interquartile range Mitral valve medicine Cardiopulmonary bypass Humans Minimally Invasive Surgical Procedures Prospective Studies Cardiac Surgical Procedures Hospital Costs Aged business.industry EuroSCORE Middle Aged National health service United Kingdom Surgery medicine.anatomical_structure 030228 respiratory system Propensity score matching Cost analysis Costs and Cost Analysis Mitral Valve Female Cardiology and Cardiovascular Medicine business Mitral valve surgery |
| Zdroj: | The Annals of thoracic surgery. 112(1) |
| ISSN: | 1552-6259 |
| Popis: | In the UK National Health Service, finite resources make the adoption of minimally invasive (MI) mitral valve surgery challenging unless greater operative costs (vs sternotomy [ST]) are balanced by postoperative savings. This study examined whether the cost analysis now became unfavorable.All patients (n = 380) undergoing isolated mitral valve surgery with or without a maze procedure over a 3-year period by either MI or ST approaches were included. Propensity matching (2 cohorts, 1:1 matched;, n = 75 per group) and multivariable regression were used to assess for the effect on cost. Cost data were prospectively collected from Service Line Reporting and reported in Sterling (£) as median (interquartile range [IQR]).Matched data revealed that total hospital costs were equivalent (MI vs ST, £16,672 [IQR, £15,044, £20,611] vs £15,875 [IQR, £12,281, £20,687]; P .33). Three of 15 costing pools were significantly different: operative costs were higher for the MI group (MI vs ST, £7458 [IQR, £6738, £8286] vs £5596 iIQR, £4204, £6992]; P.001), whereas ward costs (boarding, nursing) (MI vs ST, £1464 [IQR, £1146, £1864] vs £1733 [IQR, £1403, £2445] P = .006) and pharmacy services (MI vs ST, £187 [IQR, £140, £239] vs £244 [IQR, £179, £375] P.001) were lower for the MI group. Hospital stay was shorter in the MI group (MI vs ST, 6 days [IQR, 5, 8 days] vs 8 days [IQR, 6, 11 days]; P.001). Multivariable regression produced similar findings.There was no difference in overall hospital cost between MI and ST mitral valve surgery: higher operative costs of MI surgery were offset by lower postoperative costs, with a 2-day shorter hospital stay. |
| Databáze: | OpenAIRE |
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