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April 12, 2022Journal of the American Heart AssociationOpen Access

Achieving quality indicator benchmarks could avoid ≈26 wait-list deaths and 200 wait-list hospitalizations annually, with an incremental net monetary benefit between $10,765 (±$8721) and $17,221 (±$8977) compared to current care.

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Why the study?

The study was designed to determine the maximum cost-effective investment in TAVI care that should be made at a health system level to meet quality indicator goals.

Do hypothetical strategies meeting TAVI quality indicator targets improve cost-effectiveness and clinical outcomes compared to current TAVI care in patients with severe aortic stenosis?

Population

Patients with severe aortic stenosis in a probabilistic patient-level simulation

Comparison

4 hypothetical strategies meeting quality indicator targets vs current TAVI care

Design

Cost-utility analysis using probabilistic patient-level simulation

Follow-up

2-year time horizon

Authors

JPJohn K. PeelRMRafael N. MirandaDNDavid Naimark

Discussion

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Member takes

Overview

Modest TAVI quality investments may be cost-effective; leaves open optimal incentive design and generalizability.

Structured PICO

Do hypothetical strategies meeting TAVI quality indicator targets improve cost-effectiveness and clinical outcomes compared to current TAVI care in patients with severe aortic stenosis?

P
Population
Patients with severe aortic stenosis undergoing TAVI in Ontario, Canada (simulated cohort)
I
Intervention
4 hypothetical strategies representing TAVI care meeting ≥1 quality indicator targets: (1) reduced wait times, (2) reduced hospital length of stay, (3) reduced pacemaker use, and (4) combined strategy
C
Comparator
Current TAVI care
O
Outcome
Incremental net monetary benefits, per-person costs, quality-adjusted life years, and clinical outcomes over a 2-year time horizon

Meeting quality improvement goals in TAVI care requires a modest annual investment but provides substantial clinical benefits and is cost-effective.

Cite This Study

Peel et al. (2022) studied this question.

synapsesocial.com/papers/6a72c6fb87f921057128acedhttps://doi.org/10.1161/jaha.121.025085
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