We sought to broaden assessment of the economic impact of percutaneous transluminal coronary angioplasty (PTCA) revascularization salvage strategies by taking into account costs, revenues, the off-setting effects of prevented clinical complications and the effects of payer mix.
Previous economic analyses of PTCA have focused on the direct costs of treatment but have not accounted either for associated revenues or for the ability of costly salvage techniques such as coronary stenting to reduce even costlier complications.
Procedural costs, revenues and contribution margins (i.e., « profit ») were measured for 765 consecutive PTCA cases to assess the economic impact of salvage techniques (prolonged heparin administration, thrombolysis, intracoronary stenting or use of perfusion balloon catheters) and clinical complications (myocardial infarction, coronary artery bypass graft surgery [CABG] or acute vessel closure with repeat PTCA).
To assess the economic impact of various salvage techniques for failed PTCA, we used actual 1995 financial data as well as models of various mixes of fee-for-service, diagnosis-related group (DRG) and capitated payers.
Under fee-for-service arrangements, most salvage techniques were profitable for the hospital.
Stents were profitable at almost any level of clinical effectiveness. (...)
Mots-clés Pascal : Dilatation instrumentale, Artère coronaire, Endoprothèse, Coût, Economie santé, Traitement, Homme, Traitement instrumental
Mots-clés Pascal anglais : Instrumental dilatation, Coronary artery, Endoprosthesis, Costs, Health economy, Treatment, Human, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0512255
Code Inist : 002B26E. Création : 13/02/1998.