van den Brand M
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
Eur Heart J. 1993 Mar;14(3):391-7. doi: 10.1093/eurheartj/14.3.391.
An inventory has been made of the practice of angioplasty in 14 European countries from 1985 onwards. The numbers of procedures performed varied in 1985 from 3 to 186 per million inhabitants, in 1991 from 52 to 716. All countries showed a steady increase, but the highest performer. Belgium, achieved only 55% of the number of angioplasties performed in 1991 in the U.S.A. No relation was found between the number of angioplasties and death rate for ischaemic heart disease, national income, number of cardiologists or spending on health care. The number of catheterization laboratories was related to the number of procedures. Prices of angioplasty disposables varied widely between countries. In 1989 Italy and Spain had very high costs, averaging almost 2500 ECU and 2000 ECU for ACS and Schneider balloon catheters respectively, while Switzerland and the U.K. were cheap with costs between 700 ECU and 500 ECU for the same products. In 1991 average prices for balloon catheters fell by 25% in Spain, while in Switzerland average prices increased by 10%, bringing the almost four-fold price difference in 1989, down to a difference of 2.5 in 1991. If the U.S.A. is taken as a standard and set against the death rate from ischaemic heart disease in Western Europe in 1991 the number of 'missing' angioplasties was 215,500, the U.K. accounting for 42% of this deficit.
对1985年起14个欧洲国家的血管成形术开展情况进行了清查。1985年,每百万居民进行的手术数量从3例到186例不等,1991年则从52例到716例。所有国家均呈稳步增长,但表现最佳的比利时在1991年进行的血管成形术数量仅为美国的55%。未发现血管成形术数量与缺血性心脏病死亡率、国民收入、心脏病专家数量或医疗保健支出之间存在关联。导管插入实验室的数量与手术数量相关。各国血管成形术一次性用品的价格差异很大。1989年,意大利和西班牙的成本非常高,ACS和施奈德球囊导管的平均成本分别接近2500欧洲货币单位和2000欧洲货币单位,而瑞士和英国则很便宜,同样产品的成本在700欧洲货币单位到500欧洲货币单位之间。1991年,西班牙球囊导管的平均价格下降了25%,而瑞士的平均价格上涨了10%,使1989年几乎四倍的价格差异降至1991年的2.5倍。如果以美国为标准,并与1991年西欧缺血性心脏病死亡率相比,“缺失”的血管成形术数量为215,500例,其中英国占这一缺口的42%。