Dataset Information

Early follow-up after open heart valve surgery reduces healthcare costs: a propensity matched study.

ABSTRACT:

Objectives

The objective was to assess differences in healthcare costs within 180 days after discharge from open heart valve surgery in an intervention group receiving early, individualised and intensified follow-up compared with a historical control group.

Methods

A cost-minimisation analysis comparing costs from a consecutive prospective cohort compared with a propensity matched cohort. Costs related to the intervention, hospital (outpatient visits and readmissions) and general practitioners (all contacts) were included. Data were obtained from electronic patient records and registry data. A logistic propensity model was used to identify the historical control group. Main results are presented as mean differences and 95% CIs based on bootstrapping.

Results

After matching, the analysis included 300 patients from the intervention group and 580 controls. The mean intervention cost was €171 (SD 79) per patient. After 180 days, the mean healthcare costs were €1284 (SD 2567) for the intervention group and €2077 (SD 4773) for the controls. The cost of the intervention group was €793 (p<0.001) less per patient. The cost differences were explained mainly by fewer readmissions, fewer overall emergency visits and fewer contacts to the general practitioner during out-of-hours in the intervention group.

Conclusions

The intervention consisting of early, individualised and intensified follow-up after open heart valve surgery significantly reduced the healthcare costs within 180 days after discharge.

SUBMITTER: Borregaard B

PROVIDER: S-EPMC6861062 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Early follow-up after open heart valve surgery reduces healthcare costs: a propensity matched study.

Borregaard Britt B Møller Jacob Eifer JE Dahl Jordi Sanchez JS Riber Lars Peter Schødt LPS Berg Selina Kikkenborg SK Ekholm Ola O Weiss Marc Gjern MG Lykking Emilie Karense EK Sibilitz Kirstine Lærum KL Sørensen Jan J

Open heart 20191111 2

<h4>Objectives</h4>The objective was to assess differences in healthcare costs within 180 days after discharge from open heart valve surgery in an intervention group receiving early, individualised and intensified follow-up compared with a historical control group.<h4>Methods</h4>A cost-minimisation analysis comparing costs from a consecutive prospective cohort compared with a propensity matched cohort. Costs related to the intervention, hospital (outpatient visits and readmissions) and general ...[more]

PMID: 31798915

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Project description:BackgroundThis study aimed to determine how concomitant tricuspid annuloplasty (TAP) affects the clinical outcomes of patients undergoing totally endoscopic mitral valve surgery.MethodsThis was a single-centre, retrospective study. Between January 2019 and June 2020, 143 patients who underwent totally endoscopic mitral valve surgery in our institution were enrolled. Ninety-two patients who underwent isolated mitral valve surgery were categorized into the minimally invasive mitral valve surgery (MIMVS) group (n=92), and patients who underwent mitral valve surgery with concomitant TAP were categorized into the MIMVS-TAP (n=51) group. Clinical data were collected from all patients, including demographic and perioperative data. We conducted propensity score matching (PSM) by using one-to-one ratio nearest-neighbour matching for baseline demographic data and tricuspid valve-related parameters. Forty patients in each group were matched in this way. Parametric and nonparametric tests were performed for data analysis.ResultsStatistically, postoperative mortality within 30 days was not significantly different between the two groups (P=1). No differences were found in serious adverse events, such as stroke or third-degree conduction block, between the two groups after 1:1 PSM (P=1 and P=0.480, respectively). The mean operation time for the MIMVS+TAP group was longer (232.13±36.05 min) than that for the MIMVS group (204.25±28.49 min; P<0.001). The same was true for the cardiopulmonary bypass (CPB) time (169.48±25.96 vs. 153.10±23.00 min; P=0.004) and aortic clamp time (110.80±17.37 vs. 101.00±14.38 min; P=0.005). The duration of the intensive care unit stay and the overall postoperative length of stay were not different between the two groups (P=0.734 and P=0.472, respectively). The postoperative systolic pulmonary artery pressure differed between the two groups [38.00±8.45 (MIMVS); 33.65±7.34 (MIMVS + TAP), P=0.022].ConclusionsOur study showed that totally endoscopic mitral valve surgery with concomitant TAP is just as safe and effective as isolated totally endoscopic mitral valve surgery, even with a long surgery duration. Our study also suggested that totally endoscopic mitral valve surgery with concomitant TAP can improve tricuspid function in patients.

Dataset Information

Early follow-up after open heart valve surgery reduces healthcare costs: a propensity matched study.

Objectives

Methods

Results

Conclusions

Publications

Early follow-up after open heart valve surgery reduces healthcare costs: a propensity matched study.

Similar Datasets

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