To determine the costs of a change in permanent pacemaker implantation policy to later implantation (day 21+) after cardiac transplantation.
Design-Retrospective review of patient records including duration of temporary pacing, time of permanent pacemaker implantation, and length of hospital stay for every patient surviving = 14 days from November 1990 to August 1995 (period 2) and for all patients in whom permanent pacemakers were implanted between May 1985 and November 1990 (period 1).
Setting-Supra-regional cardiopulmonary transplant unit.
Patients-335 consecutive adult cardiac transplant recipients at Freeman Hospital between May 1985 and August 1995.
Main outcome measures-The cost of the policy change was calculated by subtraction of the overall saving in pacemaker implantations from the overall cost of the extra inpatient stay in period 2 due to delayed implantation.
Mean inpatient stay per patient following cardiac transplantation of permanent pacemaker recipients in period 1 was 13.8 days compared with 23.9 days in period 2 (P<0.001).
The cost of this extended hospital stay is £60 095.
Had the implantation policy not been changed, a further seven patients would have received a permanent pacemaker in period 2. A saving in pacemaker hardware of £16 275 was made. (...)
Mots-clés Pascal : Homotransplantation, Coeur, Pacemaker, Permanente, Postopératoire, Coût, Economie santé, Audit, Traitement, Homme, Transplantation, Chirurgie, Traitement instrumental, Stimulation instrumentale
Mots-clés Pascal anglais : Homotransplantation, Heart, Pacemaker, Permanent waving, Postoperative, Costs, Health economy, Audit, Treatment, Human, Transplantation, Surgery, Instrumentation therapy, Instrumental stimulation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0039636
Code Inist : 002B25E. Création : 21/05/1997.