Acute and long-term cost implications of coronary stenting.
OBJECTIVES We compared the acute and one year medical costs and outcomes of coronary stenting with those for balloon angioplasty (percutaneous transluminal coronary angioplasty) in contemporary clinical practice.
BACKGROUND While coronary stent implantation reduces the need for repeat revascularization, it has been associated with significantly higher acute costs compared with coronary angioplasty.
METHODS We studied patients treated at Duke University between September 1995 and June 1996 who received either coronary stent (n=384) or coronary angioplasty (n=159) and met eligibility criteria.
Detailed cost data were collected initially and up to one year following the procedure.
Our primary analyses compared six and 12 month cumulative costs for coronary angioplasty-and stent-treated cohorts.
We also compared treatment costs after excluding nontarget vessel interventions ; after limiting analysis to those without prior revascularization ; and after risk-adjusting cumulative cost estimates.
RESULTS Baseline clinical characteristics were generally similar between the two treatment groups.
The mean in-hospital cost for stent patients was $3,268 higher than for those receiving coronary angioplasty (514,802 vs. $11,534, p<0.001).
However, stent patients were less likely to be rehospitalized (22% vs. 34%, p=0.002) or to undergo repeat revascularization (9% vs. 26%, p=0.001) than coronary angioplasty patients within six months of the procedure. (...)
Mots-clés Pascal : Dilatation instrumentale, Artère coronaire, Endoprothèse, Analyse coût, Economie santé, Long terme, Etude longitudinale, Traitement, Pronostic, Homme, Traitement instrumental
Mots-clés Pascal anglais : Instrumental dilatation, Coronary artery, Endoprosthesis, Cost analysis, Health economy, Long term, Follow up study, Treatment, Prognosis, Human, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0284895
Code Inist : 002B26E. Création : 16/11/1999.