Department of Cardiothoracic Surgery, University of Oslo, Oslo, Norway.
Scand Cardiovasc J. 2012 Dec;46(6):345-52. doi: 10.3109/14017431.2012.724177. Epub 2012 Oct 18.
Transcatheter aortic valve implantation (TAVI) offers a new treatment option for patients with severe symptomatic aortic valve stenosis, classified as "inoperable". The purpose of the study was to reveal the association between ascertained hospital costs with the actual patient Diagnosis-Related Group (DRG).
We examined 50 consecutive patients who underwent either transapical TAVI, (TAVI-TA) or transfemoral TAVI (TAVI-TF) with the Edwards SAPIEN valve and CoreValve(®) between September 2009 and August 2011.
Fourty-nine patients had successful valve deployment. Seven patients died within 30 days of the operation. The mean length of hospital stay for TAVI-TA was 199 hours (range 77-362), and the mean costs for TAVI-TA were 55,690 US$. For TAVI-TF the mean length of hospital stay was 170 hours (range 49-276) and the mean costs were 52,087 US$.
There was no significant difference between TAVI-TA and TAVI-TF patient characteristics. There was a significant discrepancy between actual hospital costs and the current Norwegian DRG reimbursement for the TAVI procedure. This discrepancy can be partly explained by excessive costs related to the introduction of a new program with new technology. Costly innovations should be considered in price-setting of reimbursement for novel technology.
经导管主动脉瓣植入术（TAVI）为严重症状性主动脉瓣狭窄患者（被归类为“不可手术”的患者）提供了一种新的治疗选择。本研究旨在揭示已确定的医院费用与实际患者诊断相关组（DRG）之间的关联。
我们检查了 2009 年 9 月至 2011 年 8 月期间接受经心尖 TAVI（TAVI-TA）或经股动脉 TAVI（TAVI-TF）的 50 例连续患者，这些患者均使用爱德华兹 SAPIEN 瓣膜和 CoreValve(®)。
49 例患者的瓣膜植入成功。7 例患者在手术后 30 天内死亡。TAVI-TA 的平均住院时间为 199 小时（范围为 77-362），TAVI-TA 的平均费用为 55690 美元。对于 TAVI-TF，平均住院时间为 170 小时（范围为 49-276），平均费用为 52087 美元。
TAVI-TA 和 TAVI-TF 患者特征之间没有显著差异。实际医院费用与当前挪威 TAVI 程序的 DRG 报销之间存在显著差异。这种差异部分可以解释为与新技术引入相关的过高成本。对于新技术的定价，应考虑昂贵的创新。
