Cost of cardiac care in the three years after coronary catheterization in a contained care system : Critical determinants and implications.
We sought to determine the clinical, angiographic, treatment and outcome correlates of the intermediate-term cost of caring for patients with suspected coronary artery disease (CAD).
To adequately predict medical costs and to compare different treatment and cost reduction strategies, the determinants of cost must be understood.
However, little is known about the correlates of costs of treatment of CAD in heterogenous patient populations that typify clinical practice.
From a consecutive series of 781 patients undergoing cardiac catheterization in 1992 to 1994, we analyzed 44 variables as potential correlates of total (direct and indirect) in-hospital, 12-and 36-month cardiac costs.
Mean (± SD) patient age was 65 ± 10 years ; 71% were men, and 45% had multiple vessel disease.
The initial treatment strategy was medical therapy alone in 47% of patients, percutaneous intervention (PI) in 30% and coronary artery bypass graft surgery (CABG) in 24%. The 36-month survival and event-free (death, infarction, CABG, PI) survival rates were 89.6 ± 0.2% and 68.4 ± 0.4%, respectively.
Median hospital and 36-month costs were $8,301 and $28,054, respectively, but the interquartile ranges for both were wide and skewed.
Models for loge costs were superior to those for actual costs.
The variances accounted for by the all-inclusive models of in-hospital, 12-and 36-month costs were 57%, 60% and 71%, respectively. (...)
Mots-clés Pascal : Cardiopathie coronaire, Homme, Cathétérisme, Coût, Economie santé, Hospitalisation, Long terme, Déterminant, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Coronary heart disease, Human, Catheterization, Costs, Health economy, Hospitalization, Long term, Determinant, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0249114
Code Inist : 002B12A03. Création : 11/09/1998.