Effects of changing clinical practice on costs and outcomes of percutaneous coronary intervention between 1998 and 2002

Denvir, Martin A.; Lee, A J; Rysdale, J; Prescott, R. J.; Eteiba, Hany; Starkey, I. R.; Pell, Jill P.; Walker, Andrew

doi:10.1136/hrt.2006.090134

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Another study that compared PCI procedural cost between two hospitals showed that the hospital with more patients with adverse risk profile incurred a higher cost. The same hospital also recorded a higher number of stent inserted and lesions treated [ 23 ]. This was consistent with our study findings in which TH, the centre with a higher cost, received a significantly higher proportion of patients with diabetes mellitus and poor cardiac status.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study

et al. 2017

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IntroductionThe increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH).MethodsThis cross-sectional study was conducted from the healthcare providers’ perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test.ResultsThe mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients’ comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost.ConclusionsThe high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.

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Section: Discussionmentioning

confidence: 99%