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Follow-up costs increase the cost disparity between endocascular and open abdomnal aortic aneurysm repair

Hayter, Catherine L; Bradshaw, Stephen R; Allen, Robert J; Guduguntla, Murali; Hardman, David

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Objective: This study compared the hospital and follow-up costs of patients who have undergone endovascular (EVAR) or open (OR) elective abdominal aortic aneurysm repair. Methods: The records of 195 patients (EVAR, n = 55; OR, n = 140) who underwent elective aortic aneurysm repair between 1995 and 2004 were reviewed. Primary costing data were analyzed for 54 EVAR and 135 OR patients. Hospital costs were divided into preoperative, operative, and postoperative costs. Follow-up costs for EVAR...[Show more]

dc.contributor.authorHayter, Catherine L
dc.contributor.authorBradshaw, Stephen R
dc.contributor.authorAllen, Robert J
dc.contributor.authorGuduguntla, Murali
dc.contributor.authorHardman, David
dc.date.accessioned2015-12-13T22:53:31Z
dc.identifier.issn0741-5214
dc.identifier.urihttp://hdl.handle.net/1885/81847
dc.description.abstractObjective: This study compared the hospital and follow-up costs of patients who have undergone endovascular (EVAR) or open (OR) elective abdominal aortic aneurysm repair. Methods: The records of 195 patients (EVAR, n = 55; OR, n = 140) who underwent elective aortic aneurysm repair between 1995 and 2004 were reviewed. Primary costing data were analyzed for 54 EVAR and 135 OR patients. Hospital costs were divided into preoperative, operative, and postoperative costs. Follow-up costs for EVAR patients were recorded, with a median follow-up time of 12 months. Results: Mean preoperative costs were slightly higher in the EVAR group (AU $961/US $733 vs AU $869/US $663; not significant). Operative costs were significantly higher in the EVAR group (AU $16,124/US $12,297 vs AU $6077/US $4635; P < .001); this was entirely due to the increased cost of the endograft (AU $10,181/US $7,765 for EVAR vs AU $476/US $363 for OR). Postoperative costs were significantly reduced in the EVAR group (AU $4719/US $3599 vs AU $11,491/US $8,764; P < .001). Total hospital costs were significantly greater in the EVAR group (AU $21,804/US $16,631 vs AU $18,437/US $14,063; P < .001). The increase in total hospital costs was due to a significant difference in graft costs, which was not offset by reduced postoperative costs. The average follow-up cost per year after EVAR was AU $1316/US $999. At 1 year of follow-up, EVAR remained significantly more expensive than OR (AU $23,120/US $17,640 vs AU $18,510/US $14,122; P < .001); this cost discrepancy increased with a longer follow-up. Conclusions: EVAR results in significantly greater hospital costs compared with OR, despite reduced hospital and intensive care unit stays. The inclusion of follow-up costs further increases the cost disparity between EVAR and OR. Because EVAR requires lifelong surveillance and has a high rate of reintervention, follow-up costs must be included in any cost comparison of EVAR and OR. The economic cost, as well as the efficacy, of new technologies such as EVAR must be addressed before their widespread use is advocated.
dc.publisherElsevier
dc.sourceJournal of Vascular Surgery
dc.subjectKeywords: abdominal aorta aneurysm; adult; aged; article; correlation analysis; cost effectiveness analysis; endovascular surgery; female; follow up; hospital cost; hospitalization; human; intensive care unit; major clinical study; male; medical record; postmarketi
dc.titleFollow-up costs increase the cost disparity between endocascular and open abdomnal aortic aneurysm repair
dc.typeJournal article
local.description.notesImported from ARIES
local.description.refereedYes
local.identifier.citationvolume42
dc.date.issued2005
local.identifier.absfor110201 - Cardiology (incl. Cardiovascular Diseases)
local.identifier.ariespublicationMigratedxPub10154
local.type.statusPublished Version
local.contributor.affiliationHayter, Catherine L, The Canberra Hospital
local.contributor.affiliationBradshaw, Stephen R, Canberra Hospital
local.contributor.affiliationAllen, Robert J, Canberra Hospital
local.contributor.affiliationGuduguntla, Murali, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationHardman, David, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.issue5
local.bibliographicCitation.startpage912
local.bibliographicCitation.lastpage918
local.identifier.doi10.1016/j.jvs.2005.07.039
dc.date.updated2015-12-11T10:56:57Z
local.identifier.scopusID2-s2.0-27644547172
CollectionsANU Research Publications

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