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Treatment patterns, costs, and mortality among Medicare beneficiaries with CIED infection

Arnold J Greenspon1, Elizabeth L Eby2, Allison A Petrilla3

  • 1Cardiac Electrophysiology Laboratory, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Pacing and Clinical Electrophysiology : PACE
|February 8, 2018
PubMed

Insights

Cardiac implantable electronic device (CIED) infections lead to high healthcare costs and mortality in Medicare beneficiaries. Preventing CIED infections is crucial to improve patient outcomes and reduce expenditures.

Area of Science:

  • Cardiology
  • Health Economics
  • Infectious Diseases

Background:

  • Cardiac implantable electronic device (CIED) infections are serious adverse events with limited real-world data on treatment and costs in Medicare.
  • This study addresses the gap by evaluating treatment pathways, healthcare expenditures, and mortality following CIED infection in Medicare beneficiaries.

Purpose of the Study:

  • To evaluate post-infection treatment pathways for CIED infections.
  • To assess associated healthcare expenditures and mortality among Medicare fee-for-service beneficiaries.
  • To identify cost drivers and inform prevention strategies.

Main Methods:

  • Retrospective cohort analysis of 5,401 Medicare beneficiaries with CIED infection from 2010-2012.
  • Patients were followed for 12 months post-infection diagnosis, categorized by device removal with or without replacement, or no intervention.
  • Healthcare resource utilization and expenditures were measured.

Main Results:

  • 64.1% of patients underwent device extraction; 39.0% had replacement, 25.1% without.
  • Hospitalization was the primary cost driver, accounting for over 50% of expenditures for those with surgical intervention.
  • Mean Medicare payments varied significantly by treatment group, with the highest for those hospitalized without device intervention ($77,397).

Conclusions:

  • Management of CIED infections in Medicare beneficiaries incurs substantial healthcare expenditures within a year post-infection.
  • High costs are driven by hospitalizations and surgical interventions like device extraction/replacement.
  • Implementing additional preventive measures for CIED infections is essential to improve patient outcomes and reduce healthcare costs.
Abstract

Keywords:
CIED infectionMedicarehealthcare costshealthcare resource utilization

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