Cost Effectiveness Analysis and Payment Policy Recommendation—Population-Based Survey with Big Data Methodology for Readmission Prevention of Patients with Paroxysmal Supraventricular Tachycardia treated with Radiofrequency Catheter Ablation

Abstract

Recurrence of paroxysmal supraventricular tachycardia (PSVT) has been reported to be lower in patients treated with radiofrequency catheter ablation (RFCA) than in those who are not. Few population-based surveys have stated the cost-effectiveness related to this treatment. We, therefore, performed a nationwide retrospective study using National Health Insurance Research Database (NHIRD) data from 2001–2012 in Taiwan. The incidence of PSVT-related admissions was computed from patients’ first admission for a primary PSVT diagnosis. There were 21,086 patients hospitalized due to first-time PSVT, of whom 13,075 underwent RFCA, with 374 recurrences (2.86%). In contrast, 1751 (21.86%) of the remaining 8011 patients who did not receive RFCA, most of whom had financial concerns, experienced PSVT recurrence. The relative PSVT recurrence risk in those who did not receive RFCA was 7.6 times (95% CI: 6.67–8.33) that of those who did undergo RFCA. In conclusion, the PSVT recurrence rate was much higher in patients who did not receive RFCA at their first admission. Furthermore, RFCA proved cost-effective, with the ratio of the incremental cost-effectiveness ratio (ICER) and gross domestic product (GDP) being only 1.15. To prevent readmission and avoid incremental cost, the authority could provide a financial supplement for every patient so that the procedure is performed, reducing the PSVT-recurrence life-years (disease-specific DALY).

Big Data and Real-World Data based Cost-Effectiveness Studies and Decision-making Models: A Systematic Review and Analysis

“…In addition to the above two, registry and observational studies were also main sources for studies without the model. We also found that four studies without models did not test the uncertainty of the study or control for confounders for assessing the effectiveness and costs ( Olivares et al, 2008 ; Isla-Tejera et al, 2013 ; Tsai et al, 2018 ; Chan et al, 2020 ). As we discussed above, the lack of these methods could bring biases to results, and it is difficult to inform decision-making by deterministic results alone ( Briggs, 2000 ; Parody-Rúa et al, 2020 ).…”

Big Data, Decision Models, and Public Health

“…A major focus of this theme is on how big data analytics can improve public health and chronic diseases [ 21 , 22 , 23 , 24 , 25 , 26 ]. The first paper, “ Study on the Impact of Income Gap on the Health Level of Rural Residents in China ”, by Guo et al [ 27 ], examined the heterogeneity of the impact of income gap on the health level of different rural households.…”

Big Data, Decision Models, and Public Health

“…Recurrence of paroxysmal supraventricular tachycardia (PSVT) has been reported to be lower in patients treated with radiofrequency catheter ablation (RFCA) than in those who are not. [14], performed a nationwide retrospective study using NHIRD data from 2001-2012 in Taiwan. There were 21,086 patients hospitalized due to first-time PSVT, of whom 13,075 underwent RFCA, with 374 recurrences (2.86%).…”

“…Few population-based surveys have stated the cost-effectiveness related to this treatment. The fifth paper, “ Cost Effectiveness Analysis and Payment Policy Recommendation—Population-Based Survey with Big Data Methodology for Readmission Prevention of Patients with Paroxysmal Supraventricular Tachycardia treated with Radiofrequency Catheter Ablation ”, by Chan et al [ 14 ], performed a nationwide retrospective study using NHIRD data from 2001–2012 in Taiwan. There were 21,086 patients hospitalized due to first-time PSVT, of whom 13,075 underwent RFCA, with 374 recurrences (2.86%).…”