Clinical correlates of the initial and long-term cost of coronary bypass surgery and coronary angioplasty.
Background Medical costs vary substantially among patients.
Understanding the baseline factors that predict subsequent cost may allow better selection of therapy for individual patients.
Understanding the postprocedure events that increase cost should help to improve efficiency and effectiveness of coronary revascularization.
Methods Data on 4-year costs were collected from patients randomly assigned to coronary angioplasty or bypass surgery as part of the BARI (Bypass Angioplasty Revascularization Investigation) trial.
Regression models first examined factors known at the time of randomization that prospectively predicted initial procedure cost and long-term cost.
Subsequent models tested the value of postrandomization events as explanatory variables for cost.
Results The independent baseline predictors of higher initial percutaneous transluminal coronary angioplasty cost included 3-vessel disease (+12%) and acute presentations (+22%), whereas the independent predictors of higher initial coronary artery bypass grafting cost included the number of comorbid conditions (+5% per condition) and female sex (+7%). The independent baseline predictors of 4-year cost included heart failure (+26%), diabetes (+22%), comorbidity (+10%), and angioplasty assignment in patients with 2-vessel disease (-15%). (...)
Mots-clés Pascal : Aortocoronaire, Etude comparative, Coût, Economie santé, Homme, Chirurgie, Long terme, Dérivation, Dilatation instrumentale, Angioplastie, Artère coronaire, Cardiopathie coronaire, Traitement instrumental, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Aortocoronary, Comparative study, Costs, Health economy, Human, Surgery, Long term, Bypass, Instrumental dilatation, Angioplasty, Coronary artery, Coronary heart disease, Instrumentation therapy, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0442644
Code Inist : 002B12A03. Création : 22/03/2000.