Same-Day Discharge Reduces Costs in Percutaneous Coronary Intervention

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PCI with same-day discharged is linked to lower costs among Medicare beneficiaries.
PCI with same-day discharged is linked to lower costs among Medicare beneficiaries.

HealthDay News — For Medicare beneficiaries undergoing percutaneous coronary intervention (PCI), transradial intervention (TRI) with same-day discharge is associated with lower costs, according to a study published in JACC: Cardiovascular Interventions.

Amit P. Amin, MD, from the Washington University School of Medicine in St. Louis, and colleagues analyzed data from 279,987 PCI patients eligible for same-day discharge in the National Cardiovascular Data Registry CathPCI Registry linked to Medicare claims files. Cost-to-charge ratios were used to estimate hospital costs in 2014 US dollars.

The researchers found that TRI was used in 9% of the procedures (13.5% of which were same-day discharge), and same-day discharge was used in 5.3% of cases (of which 23.1% were TRI). Compared with transfemoral intervention, TRI correlated with lower adjusted costs of $916, as was same-day discharge ($3,502). The adjusted cost associated with TRI and same-day discharge was $13,389, compared with costs of $17,076 associated with the transfemoral intervention and non-same-day discharge (difference of $3,689; P <.0001). The investigators estimated that a 30% shift from current practice to TRI same-day discharge could potentially save $1 million at a hospital performing 1,000 PCIs each year, and $300 million annually nationwide.

"These findings have important implications for changing the current PCI care pathways to improve outcomes and reduce costs," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry. The study was funded by Vita Solutions, a subsidiary of The Medicines Company.

References

  1. Amin APP, Patterson M, House JA. Costs associated with access site and same-day discharge among medicare beneficiaries undergoing percutaneous coronary intervention. JACC Cardiovasc Interv. 2017;10(4):342-351. doi: 10.1016/j.jcin.2016.11.049
  2. Ladapo JA. Strengths and limitations of using cost evaluations to inform cardiovascular care. JACC Cardiovasc Interv. 2017;10(4):352-354. doi: 10.1016/j.jcin.2016.12.011
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