Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study

ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the...

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Published in:BMJ open 2021-12, Vol.11 (12), p.e053305-e053305
Main Authors: Lee, Peter, Brennan, Angela L, Stub, Dion, Dinh, Diem T, Lefkovits, Jeffrey, Reid, Christopher M, Zomer, Ella, Liew, Danny
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angina pectoris
Angina, Unstable
Angioplasty
cardiology
Cardiovascular disease
Cardiovascular Medicine
Cerebrovascular disease
coronary intervention
Cost estimates
Datasets
Expenditures
Funding
Health Care Costs
health economics
Heart attacks
Humans
Length of stay
Mortality
myocardial infarction
Patients
Percutaneous Coronary Intervention - methods
Registries
Regression analysis
Treatment Outcome
Trends
Variables
Victoria
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Brennan, Angela L
Stub, Dion
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Liew, Danny
description ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the Australian healthcare system perspective.SettingA linked dataset of patients admitted to public hospitals for PCI in Victoria was drawn from the Victorian Cardiac Outcomes Registry (VCOR) and the Victorian Admitted Episodes Dataset. Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.
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Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2021-053305</identifier><identifier>PMID: 34876433</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Acute coronary syndromes ; Angina pectoris ; Angina, Unstable ; Angioplasty ; cardiology ; Cardiovascular disease ; Cardiovascular Medicine ; Cerebrovascular disease ; coronary intervention ; Cost estimates ; Datasets ; Expenditures ; Funding ; Health Care Costs ; health economics ; Heart attacks ; Humans ; Length of stay ; Mortality ; myocardial infarction ; Patients ; Percutaneous Coronary Intervention - methods ; Registries ; Regression analysis ; Treatment Outcome ; Trends ; Variables ; Victoria</subject><ispartof>BMJ open, 2021-12, Vol.11 (12), p.e053305-e053305</ispartof><rights>Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2021 Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b473t-1aa75edcf3260dd93e5755d32d04a459aeb3de674f1184a2ca23e54a281b524a3</citedby><cites>FETCH-LOGICAL-b473t-1aa75edcf3260dd93e5755d32d04a459aeb3de674f1184a2ca23e54a281b524a3</cites><orcidid>0000-0001-7059-1959</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2607499451/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2607499451?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,3213,25783,27957,27958,37047,37048,44625,53827,53829,55696,55705,75483</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34876433$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Peter</creatorcontrib><creatorcontrib>Brennan, Angela L</creatorcontrib><creatorcontrib>Stub, Dion</creatorcontrib><creatorcontrib>Dinh, Diem T</creatorcontrib><creatorcontrib>Lefkovits, Jeffrey</creatorcontrib><creatorcontrib>Reid, Christopher M</creatorcontrib><creatorcontrib>Zomer, Ella</creatorcontrib><creatorcontrib>Liew, Danny</creatorcontrib><title>Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><addtitle>BMJ Open</addtitle><description>ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the Australian healthcare system perspective.SettingA linked dataset of patients admitted to public hospitals for PCI in Victoria was drawn from the Victorian Cardiac Outcomes Registry (VCOR) and the Victorian Admitted Episodes Dataset. Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. 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Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>34876433</pmid><doi>10.1136/bmjopen-2021-053305</doi><orcidid>https://orcid.org/0000-0001-7059-1959</orcidid><oa>free_for_read</oa></addata></record>
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source BMJ Open Access Journals; Publicly Available Content Database; PubMed Central; British Medical Journals Online Archive (BMJ)
subjects Acute coronary syndromes
Angina pectoris
Angina, Unstable
Angioplasty
cardiology
Cardiovascular disease
Cardiovascular Medicine
Cerebrovascular disease
coronary intervention
Cost estimates
Datasets
Expenditures
Funding
Health Care Costs
health economics
Heart attacks
Humans
Length of stay
Mortality
myocardial infarction
Patients
Percutaneous Coronary Intervention - methods
Registries
Regression analysis
Treatment Outcome
Trends
Variables
Victoria
title Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study
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