In-hospital cost of percutaneous coronary revascularization : critical determinants and implications.
Background Hospital charges associated with percutaneous transluminal coronary revascularization (PTCR) in the United States exceeded $6 billion in 1994 and are likely to be constrained in some manner in the near future.
Despite this high cost to the public, little is known about the major determinants and sources of variability of PTCR.
Methods and Results From a consecutive series of 1258 procedures with attempted PTCR at a single tertiary referral center, we analyzed 65 clinical, angiographic, physician, and outcome variables as potential correlates of total (hospital and physician) cost.
Direct and indirect costs, both hospital and physician, were determined on the basis of resource utilization using « top-down » methodology and were available for 1237 procedures (1086 patients) (98.3%). Procedural success was obtained in 89%, and major complications (death, bypass surgery, or Q-wave myocardial infarction) occurred in 3.8%. Conclusions The range of total hospital costs associated with percutaneous intervention is extraordinarily wide.
Baseline patient characteristics account for nearly half of the explained variance, but procedural complications and system delays account for much of the remainder.
Mots-clés Pascal : Dilatation instrumentale, Voie percutanée, Artère coronaire, Analyse coût, Economie santé, Traitement, Homme, Traitement instrumental
Mots-clés Pascal anglais : Instrumental dilatation, Percutaneous route, Coronary artery, Cost analysis, Health economy, Treatment, Human, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0483879
Code Inist : 002B26E. Création : 01/03/1996.