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

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...

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Bibliographic Details
Published in:The American journal of cardiology 2016-01, Vol.117 (1), p.121-126
Main Authors: O'Byrne, Michael L., MD, MSCE, Gillespie, Matthew J., MD, Shinohara, Russell T., PhD, Dori, Yoav, MD, PhD, Rome, Jonathan J., MD, Glatz, Andrew C., MD, MSCE
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Cardiac Catheterization - economics
Cardiac Catheterization - methods
Cardiovascular
Child
Children & youth
Costs
Female
Generalized linear models
Health Care Costs
Health Information Systems
Heart surgery
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - economics
Heart Valve Prosthesis Implantation - methods
Hospitals
Humans
Information systems
Intubation
Male
Metabolic disorders
Mortality
Propensity Score
Pulmonary Valve - surgery
Pulmonary Valve Insufficiency - economics
Pulmonary Valve Insufficiency - surgery
Retrospective Studies
Studies
Treatment Outcome
United States
Young Adult
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Summary: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
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.10.011