Cost comparison of Transcatheter and Operative Pulmonary Valve Replacement (from the Pediatric Health Information Systems Database)

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• 作者：Michael L. O'Byrne ; MD ; MSCE^a ; ^b ; ^{mlobyrne@childrensnational.org" class="auth_mail" title="E-mail the corresponding author} ; Matthew J. Gillespie ; MD^c ; ^d ; Russell T. Shinohara ; PhD^c ; ^d ; Yoav Dori ; MD ; PhD^c ; ^d ; Jonathan J. Rome ; MD^c ; ^d ; Andrew C. Glatz ; MD ; MSCE^c ; ^d ; ^e
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：1 January 2016
• 年：2016
• 卷：117
• 期：1
• 页码：121-126
• 全文大小：304 K

文摘

Outcomes for transcatheter pulmonary valve replacement (TC-PVR) and operative pulmonary valve replacement (S-PVR) are excellent. Thus, their respective cost is a relevant clinical outcome. We performed a retrospective cohort study of children and adults who underwent PVR at age ≥8 years from January 1, 2011, to December 31, 2013, at 35 centers contributing data to the Pediatric Health Information Systems database to address this question. A propensity score–adjusted multivariable analysis was performed to adjust for known confounders. Secondary analyses of department-level charges, risk of re-admission, and associated costs were performed. A total of 2,108 PVR procedures were performed in 2,096 subjects (14% transcatheter and 86% operative). The observed cost of S-PVR and TC-PVR was not significantly different (2013US $50,030 vs 2013US $51,297; p = 0.85). In multivariate analysis, total costs of S-PVR and TC-PVR were not significantly different (p = 0.52). Length of stay was shorter after TC-PVR (p <0.0001). Clinical and supply charges were greater for TC-PVR (p <0.0001), whereas laboratory, pharmacy, and other charges (all p <0.0001) were greater for S-PVR. Risks of both 7- and 30-day readmission were not significantly different. In conclusion, short-term costs of TC-PVR and S-PVR are not significantly different after adjustment.