Financial and resource costs of transvenous lead extraction in a high-volume lead extraction centre.
In: Heart, Jg. 106 (2020-06-15), Heft 12, S. 931-937
academicJournal
Zugriff:
Objectives: Transvenous lead extraction (TLE) poses a significant economic and resource burden on healthcare systems; however, limited data exist on its true cost. We therefore estimate real-world healthcare reimbursement costs of TLE to the UK healthcare system at a single extraction centre. Methods: Consecutive admissions entailing TLE at a high-volume UK centre between April 2013 and March 2018 were prospectively recorded in a computer registry. In the hospital's National Health Service (NHS) clinical coding/reimbursement database, 447 cases were identified. Mean reimbursement cost (n=445) and length of stay (n=447) were calculated. Ordinary least squares regressions estimated the relationship between cost (bed days) and clinical factors. Results: Mean reimbursement cost per admission was £17 399.09±£13 966.49. Total reimbursement for all TLE admissions was £7 777 393.51. Mean length of stay was 16.3±15.16 days with a total of 7199 bed days. Implantable cardioverter-defibrillator and cardiac resynchronisation therapy defibrillator devices incurred higher reimbursement costs (70.5% and 68.7% higher, respectively, both p<0.001). Heart failure and prior valve surgery also incurred significantly higher reimbursement costs. Prior valve surgery and heart failure were associated with 8.3 (p=0.017) and 5.5 (p=0.021) additional days in hospital, respectively. Conclusions: Financial costs to the NHS from TLE are substantial. Consideration should therefore be given to cost/resource-sparing potential of leadless/extravascular cardiac devices that negate the need for TLE particularly in patients with prior valve surgery and/or heart failure. Additionally, use of antibiotic envelopes and other interventions that reduce infection risk in patients receiving transvenous leads should be considered. [ABSTRACT FROM AUTHOR]
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Titel: |
Financial and resource costs of transvenous lead extraction in a high-volume lead extraction centre.
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Autor/in / Beteiligte Person: | Gould, Justin ; Sidhu, Baldeep S. ; Porter, Bradley ; Sieniewicz, Benjamin J. ; Freeman, Scott ; de Wilt, Evelien C. J. ; Glover, Julia C. ; Razavi, Reza ; Rinaldi, Christopher A. ; de Wilt, Evelien Cj |
Zeitschrift: | Heart, Jg. 106 (2020-06-15), Heft 12, S. 931-937 |
Veröffentlichung: | 2020 |
Medientyp: | academicJournal |
ISSN: | 1355-6037 (print) |
DOI: | 10.1136/heartjnl-2019-315839 |
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