CABG in the United States was associated with 82.5% higher in-hospital costs compared to Canada ($20,673 vs $10,373, P<.001), with no difference in in-hospital mortality.
Observational (n=12,017)
Yes
Does coronary artery bypass graft surgery (CABG) in the United States compared to Canada result in different in-hospital outcomes and costs?
In-hospital costs for CABG are substantially higher in the United States compared to Canada, without yielding superior in-hospital clinical outcomes.
Effect estimate: 82.5% higher
Absolute Event Rate: 20673% vs 10373%
p-value: p=<.001
BACKGROUND: We sought to determine whether there is a difference in in-hospital outcomes and costs for coronary artery bypass graft surgery (CABG) between the United States and Canada. METHODS: We compared the outcomes and costs of treating 12 017 consecutive patients (4698 US and 7319 Canadian patients) undergoing CABG at 5 US and 4 Canadian hospitals. Participating hospitals used the same cost accounting system to provide patient-level clinical, resource utilization, and cost-of-treatment data (excluding physicians' fees). Canadian costs were converted to US dollars using purchasing power parities. RESULTS: Compared with Canadian patients, US patients were older (mean +/- SD age, 68.0 +/- 10.4 vs 63.7 +/- 9.8 years P<.001), more likely to be female (27.4% vs 21.8% P<.001), and discharged from the hospital sooner (mean +/- SD length of stay, 8.7 +/- 0.1 vs 9.5 +/- 0.1 days P<.001). In-hospital costs of treatment were substantially higher in the United States than in Canada (mean +/- SD cost, dollar 20,673 +/- dollar 241 vs dollar 10,373 +/- dollar 123 P<.001; median, dollar 16,036 vs dollar 7880). After controlling for demographic and clinical differences, length of stay in Canada was 16.8% longer than in the United States; there was no difference in in-hospital mortality; and the cost in the United States was 82.5% higher than in Canada (P<.001). CONCLUSIONS: The in-hospital cost of CABG in the United States is substantially higher than in Canada. This difference is due to higher direct and overhead costs in US hospitals, is not explained by demographic or clinical differences, and does not lead to superior clinical outcomes.
Eisenberg et al. (Mon,) conducted a observational in Coronary artery disease requiring CABG (n=12,017). CABG in the United States vs. CABG in Canada was evaluated on In-hospital cost of treatment (82.5% higher, p=<.001). CABG in the United States was associated with 82.5% higher in-hospital costs compared to Canada ($20,673 vs $10,373, P<.001), with no difference in in-hospital mortality.
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