This study sought to evaluate the cost-effectiveness of primary angioplasty for acute myocardial infarction under varying assumptions about effectiveness, existing facilities and staffing and volume of services.
Primary angioplasty for acute myocardial infarction has reduced mortality in some studies, but its actual effectiveness may vary, and most U.S. hospitals do not have cardiac catheterization laboratories.
Projections of cost-effectiveness in various settings are needed for decisions about adoption.
We created a decision analytic model to compare three policies : primary angioplasty, intravenous thrombolysis and no intervention.
Probabilities of health outcomes were taken from randomized trials (base case efficacy assumptions) and community-based studies (effectiveness assumptions).
The base case analysis assumed that a hospital with an existing laboratory with night/weekend staffing coverage admitted 200 patients with a myocardial infarction annually.
In alternative scenarios, a new laboratory was built, and its capacity for elective procedures was either 1) needed or 2) redundant with existing laboratories.
Under base case efficacy assumptions, primary angioplasty resulted in cost savings compared with thrombolysis and had a cost of $12,000/quality-adjusted life-year (QALY) saved compared with no intervention. (...)
Mots-clés Pascal : Infarctus, Myocarde, Aigu, Dilatation instrumentale, Artère coronaire, Primaire, Analyse coût efficacité, Economie santé, Traitement, Pronostic, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Traitement instrumental
Mots-clés Pascal anglais : Infarct, Myocardium, Acute, Instrumental dilatation, Coronary artery, Primary, Cost efficiency analysis, Health economy, Treatment, Prognosis, Human, Cardiovascular disease, Coronary heart disease, Myocardial disease, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0033459
Code Inist : 002B12A03. Création : 17/04/1998.