Key result
Same-day discharge for pulmonary vein isolation linked to ~€316 lower healthcare costs per patient.
Why the study?
Same-day discharge after pulmonary vein isolation is a strategic approach to reduce procedure-related costs, but its impact on healthcare utilization, costs, and clinical outcomes needed evaluation.
Does the implementation of a same-day discharge protocol reduce healthcare utilization and costs without increasing complications in patients undergoing pulmonary vein isolation for atrial fibrillation?
Cohort (n=2,987)
No
Does the implementation of a same-day discharge protocol reduce healthcare utilization and costs without increasing complications in patients undergoing pulmonary vein isolation for atrial fibrillation?
Mean Difference: -316.06
Absolute Event Rate: 840.37% vs 1152.94%
p-value: p=<0.001
The implementation of a same-day discharge protocol for pulmonary vein isolation is safe and significantly reduces per-patient healthcare resource utilization and costs.
Same-day discharge after PVI was associated with lower costs without more complications; leaves open need for randomized confirmation before practice change.
Aims Pulmonary vein isolation (PVI) is an effective intervention to treat atrial fibrillation, which is increasingly prevalent. Same-day discharge (SDD) is a strategic approach to limit procedure-related costs. This study aimed to compare healthcare utilization, costs, and clinical outcomes before and after implementation of an SDD protocol. Methods and results This retrospective study included 2987 patients undergoing PVI between 1 January 2016 and 1 April 2021. Baseline characteristics, pre-, peri-, and post-procedure healthcare utilization and clinical outcomes were compared before (cohort A; n = 1379) and after (Cohort B; n = 1608) implementation of the SDD protocol using bivariate and multivariate analyses. show that cohort B vs. cohort A had lower all-cause 90-day mortality (0% vs. 0.3%, P = 0.031), no differences in re-ablation < 1 year (P = 0.286), as well as in complications: bleedings (P = 0.177), tamponade < 30 days (P = 0.157), phrenic nerve injury (P = 0.984), thromboembolic complication < 72 h (P = 0.212), or vascular complications (P = 0.290). In terms of healthcare utilization and costs, cohort B had significantly less peri-procedure hospital admission costs (€721.52 vs. €1011.78, P < 0.001) and less total peri- and post-procedure costs (€840.37 vs. €1152.94, P < 0.001). Adjusted for all baseline characteristics, the post-implementation cohort showed on average €315 lower total costs per patient. Conclusion The implementation of the SDD protocol was associated with comparable complication rates while significantly reducing both peri- and post-procedure healthcare utilization and costs, thereby enhancing patient value. This indicates a potential margin for further cost reductions and increased efficiency.
No takes yet. Share an insight, caveat, or question.
Slingerland et al. (2026) conducted a cohort in Atrial fibrillation undergoing pulmonary vein isolation (n=2,987). Same-day discharge protocol vs. Overnight stay protocol (pre-implementation) was evaluated on Total peri- and post-procedure costs (B = -316.06, p=<0.001). Implementation of a same-day discharge protocol for pulmonary vein isolation reduced total peri- and post-procedure healthcare costs by an adjusted average of €316 per patient, without increasing complications.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: