University of Maryland Medical Center, Baltimore, USA.
University of Maryland Medical System, Baltimore, USA.
J Interv Card Electrophysiol. 2022 Mar;63(2):231-237. doi: 10.1007/s10840-021-00956-6. Epub 2021 Feb 11.
Many studies have analyzed the cost-effectiveness of implantable cardioverter defibrillators (ICDs), but hospital costs have not been as thoroughly reported. This study reviewed the associated hospital costs for non-surgical patients who received ICDs from 2015 to 2019.
We performed a retrospective single-center analysis of patients who received an ICD between 2015 and 2019. ICD cost was analyzed with respect to time using linear regression t-test analysis.
For 304 patients, we trended cost of the devices over time. 168 (55.2%) cases were single-chamber devices, 53 (17.4%) were dual-chamber, 59 (19.4%) were cardiac resynchronization therapy-defibrillators (CRT-D), and 24 (7.9%) were subcutaneous devices. The cost of all ICDs decreased by -$1.82/day (p<0.001), R = 0.056. By type, cost of single-chamber devices decreased by -$2.56/day (p<0.001), R = 0.47, dual-chamber ICD by -$3.50/day (p<0.001), R = 0.51, CRT-D by -$4.07/day (p<0.001), R = 0.47, and subcutaneous by -$3.33/day (p<0.001), R = 0.83.
This is the first detailed analysis of ICD costs that we are aware of. The cost of all ICDs decreased modestly and became much greater when categorized by type. Overall hospital cost associated with ICD implantation did not show a significant trend, but total supply cost showed a significant decrease over time.
许多研究已经分析了植入式心脏复律除颤器(ICD)的成本效益,但医院成本并未得到充分报告。本研究回顾了 2015 年至 2019 年期间接受 ICD 的非手术患者的相关医院成本。
我们对 2015 年至 2019 年期间接受 ICD 的患者进行了回顾性单中心分析。使用线性回归 t 检验分析随时间推移对 ICD 成本进行分析。
对于 304 名患者,我们分析了设备随时间推移的成本趋势。168 例(55.2%)为单腔设备,53 例(17.4%)为双腔设备,59 例(19.4%)为心脏再同步治疗除颤器(CRT-D),24 例(7.9%)为皮下设备。所有 ICD 的成本每天降低 -1.82 美元(p<0.001),R = 0.056。按类型划分,单腔设备的成本每天降低 -2.56 美元(p<0.001),R = 0.47,双腔 ICD 降低 -3.50 美元/天(p<0.001),R = 0.51,CRT-D 降低 -4.07 美元/天(p<0.001),R = 0.47,皮下降低 -3.33 美元/天(p<0.001),R = 0.83。
这是我们所知的第一个关于 ICD 成本的详细分析。所有 ICD 的成本都适度下降,按类型分类则下降幅度更大。与 ICD 植入相关的总体医院成本没有显示出显著趋势,但总供应成本随着时间的推移显示出显著下降。