Cost – Benefit Analysis of Focused Pre-Operative Transthoracic Echocardiography in the Pre-Operative Clinic in Patients at Increased Cardiac Risk Presenting for Non-Cardiac Surgery - A Pilot Study

Background and aims: In a prospective observational study, focused transthoracic echocardiography (TTE) performed in the preoperative clinic on 100 patients with increased cardiac risk resulted in a change in management of 54% and a net reduction in use of hospital resources. The aims of this study are to apply a cost benefit analysis to demonstrate whether or not this translated into saving money for the hospital. Methods: Data from a previous study examining management changes resulting from preoperative focused TTE were collated. Cost estimates were obtained for management changes, and total costs and savings were calculated in Australian dollars. Results: The use of focused TTE in the perioperative period may have saved a total of $ 22,772.32 or $ 227 for each patient (n=100). Based on the performance of two focused TTE examinations each day in the preoperative clinic, a potential saving of greater than $ 100,000 per year is estimated. Conclusion: This pilot study demonstrates proof of concept that focused transthoracic echocardiography performed before elective non-cardiac surgery may be more cost-effective than conventional comprehensive transthoracic echocardiography.