logo BDSP

Base documentaire


Votre avis nous intéresse

Le réseau BDSP met en oeuvre un projet d'innovation et d'amélioration de ses services, dans le souci constant de proposer des contenus de qualité adaptés aux besoins des utilisateurs.

Identifier de nouvelles sources de financements est la condition nécessaire pour assurer la poursuite et la pérennité de cet outil unique qu'est la BDSP, tout en le faisant évoluer.

Pour définir un nouveau modèle économique, nous avons besoin de votre avis : merci de répondre à notre enquête (temps estimé : 5 minutes).

Participer maintenant
Participer plus tard J'ai déjà participé

  1. Economic impact on physicians and hospitals of proposed changes in Medicare reimbursement for coronary interventions.

    Article - En anglais

    Background The federal government is implementing changes in reimbursement for angioplasty and coronary stenting.

    These include reductions in physician reimbursement and a redesignation of intracoronary stents to a different diagnosis-related group than other methods of intracoronary intervention.

    Objective The aim of this study was to examine the financial impact on physicians and hospitals of proposed federal reimbursement policies for percutaneous coronary revascularization procedures.

    Methods We modeled the financial effects of 3 different stenting strategies :

    • strategy I is the most conservative, with stents reserved for addressing lab complications ;

    • strategy II stents are used for suboptimal results after attempts at conventional percutaneous transluminal coronary angioplasty (PTCA) ;

    • strategy III is the most aggressive, with initial stenting of all accessible lesions.

    We used economic data on PTCA and stent costs from a 1996 dataset and made assumptions about PTCA and stent success rates and restenosis rates based on published data.

    Results Under current reimbursement policies, physician revenues and profits are approximately equal under all 3 stenting strategies.

    After the proposed changes, there is a slight financial incentive for physicians to pursue the more aggressive strategy III, but the major financial effect is a substantial overall decline in revenues with any of the 3 strategies. (...)

    Mots-clés Pascal : Dilatation instrumentale, Artère coronaire, Endoprothèse, Resténose, Economie santé, Analyse coût, Hôpital, Médecin, Traitement, Homme, Traitement instrumental

    Mots-clés Pascal anglais : Instrumental dilatation, Coronary artery, Endoprosthesis, Restenosis, Health economy, Cost analysis, Hospital, Physician, Treatment, Human, Instrumentation therapy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0148125

    Code Inist : 002B26E. Création : 16/11/1999.