Myocardial Revascularization / economics

ABC

Editorial

Better Technology, More Spending, Worse Outcomes

Since its beginning, myocardial revascularization has suffered substantial technological changes. In fact, early techniques with no physiological basis were used to increase blood supply to the ischemic myocardium. These included pericardial talc insufflation, coronary sinus ligation, Beck surgical procedure, and the Vineberg procedure. Nevertheless, due to their frustrating results that did not meet the expectations, these techniques were abandoned.

The emergence of a new, more rational technique – the coronary artery bypass surgery using venous grafts (later substituted with arterial grafts) – enabled the provision of greater blood flow to the ischemic myocardium.

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IJCS

Original Article

Impact of Risk Factors for Coronary Artery Disease on Hospital Costs of Patients Undergoing Myocardial Revascularization Surgery in the Brazilian Unified Health System (SUS)

João Luis Barbosa et al. Clarissa Antunes Thiers Carlos Felipe dos Santos Cunha Juliana Moutella … Bernardo Rangel Tura Giulia Principe Orsi Karen Feldman Nathália Rodrigues da Silva Luiz Felipe Faria

Abstract

Background:

Cardiovascular diseases are a major cause of mortality and morbidity. Myocardial revascularization surgery may be indicated for the relief of symptoms and to reduce mortality. However, surgery is a costly procedure and the impact of the number of cardiovascular risk factors on the cost of the procedure has not been established.

Objectives:

To identify the impact of risk factors for coronary artery disease on myocardial revascularization surgery cost.

Methods:

We selected 239 patients undergoing myocardial revascularization surgery at the National Institute of Cardiology in the period from 01 January to 31 December 2013. We included patients aged over 30 years, with indication for the procedure. Patients undergoing combined procedures were excluded.

Results:

Seven patients had only one risk factor, 32 patients had two risk factors, 75 patients had 3 risk factors, 78 patients had four risk factors, 36 patients had 5 risk factors and 11 patients presented 6 risk factors. The total costs, on average, was R$ 14,143.22 in the group with 1 risk factor, R$ 18,380.40 in the group with 2 risk factors, R$ 21,229.51 in the group with 3 risk factors, R$ 24,620.86 in the group with 4 risk factors, R$ 21,337.92 in the group with 5 risk factors and R$ 36,098,35 in the group with 6 risk factors (p = 0.441).

Conclusion:

This study demonstrates that, in a public referral center for highly complex cardiology procedures, there was no significant correlation between the number of cardiovascular risk factors and hospitalization costs.