Fontan palliation versus heart transplantation : A comparison of charges.
Surgical approaches to single-ventricle physiologic abnormalities have included Fontan palliation or transplantation.
No cost expenditures have been published.
This study compared expenditures between the Fontan procedure and heart transplantation.
Between 1988 and 1992, records of 82 patients who underwent the Fontan procedure and 26 who underwent transplant were retrospectively reviewed.
Charges for Fontan or transplant procedures were accrued from the date of surgical admission until discharge or patient death and included hospital, physician, and diagnostic laboratory charges.
Additionally, the frequency and cost of postoperative hospital readmissions, outpatient evaluations, and diagnostic procedures were recorded for each patient.
Estimated expenditures for each evaluated parameter were based on 1992 to 1993 dollar charges.
The total expenditure (surgery plus yearly follow-up) for transplantation exceeded that for the Fontan procedure ($96,475 vs $29,730 ; p<0.001).
Although both groups had similar follow-up periods and mortality rates, the number of hospital readmissions and postoperative diagnostic tests was higher among transplant recipients.
Within 1 postoperative year at least four high-risk patients who had undergone a Fontan procedure required listing for transplantation ; the total costs of their combined procedures (approximately $80,000+$3,000 to $5,000 annual outpatient charges) was markedly greater than the cost of the Fontan procedure alone. (...)
Mots-clés Pascal : Homotransplantation, Coeur, Intervention Fontan, Coût, Economie santé, Etude comparative, Traitement, Homme, Transplantation, Chirurgie
Mots-clés Pascal anglais : Homotransplantation, Heart, Fontan operation, Costs, Health economy, Comparative study, Treatment, Human, Transplantation, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0305022
Code Inist : 002B25E. Création : 10/04/1997.