Key result
Hospitalization costs for acute coronary syndrome were significantly higher for patients undergoing CABG (R$ 40,883) and stenting (R$ 37,454) compared to clinical treatment alone (R$ 18,261).
Why the study?
What are the hospitalization costs and length of stay associated with different treatment strategies for acute coronary syndrome in the Brazilian Supplementary Health System?
Cohort (n=2,876)
Yes
What are the hospitalization costs and length of stay associated with different treatment strategies for acute coronary syndrome in the Brazilian Supplementary Health System?
p-value: p=<0.001
Hospitalization costs for ACS in the Brazilian Supplementary Health System are high and significantly increase when interventional procedures like PCI or CABG are required.
Higher ACS costs with revascularization should not yet change practice; observational data leave open adjusted value and outcome questions in supplementary systems.
BACKGROUND: Acute coronary syndrome (ACS) is defined as a "group of clinical symptoms compatible with acute myocardial ischemia", representing the leading cause of death worldwide, with a high clinical and financial impact. In this sense, the development of economic studies assessing the costs related to the treatment of ACS should be considered. OBJECTIVE: To evaluate costs and length of hospital stay between groups of patients treated for ACS undergoing angioplasty with or without stent implantation (stent+ / stent-), coronary artery bypass surgery (CABG) and treated only clinically (Clinical) from the perspective of the Brazilian Supplementary Health System (SHS). METHODS: A retrospective analysis of medical claims of beneficiaries of health plans was performed considering hospitalization costs and length of hospital stay for management of patients undergoing different types of treatment for ACS, between Jan/2010 and Jun/2012. RESULTS: The average costs per patient were R$ 18,261.77, R$ 30,611.07, R$ 37,454.94 and R$ 40,883.37 in the following groups: Clinical, stent-, stent+ and CABG, respectively. The average costs per day of hospitalization were R$ 1,987.03, R$ 4,024.72, R$ 6,033.40 and R$ 2,663.82, respectively. The average results for length of stay were 9.19 days, 7.61 days, 6.19 days and 15.20 days in these same groups. The differences were significant between all groups except Clinical and stent- and between stent + and CABG groups for cost analysis. CONCLUSION: Hospitalization costs of SCA are high in the Brazilian SHS, being significantly higher when interventional procedures are required.
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Teich et al. (2015) conducted a cohort in Acute Coronary Syndrome (n=2,876). Interventional procedures (angioplasty with/without stent, CABG) vs. Clinical treatment only was evaluated on Average hospitalization costs per patient (p=<0.001). Hospitalization costs for acute coronary syndrome were significantly higher for patients undergoing CABG (R$ 40,883) and stenting (R$ 37,454) compared to clinical treatment alone (R$ 18,261).
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