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Day case complex devices: the state of the UK
Michael Waight1, Abdula Elawady1, Heather Gage2
1Cardiology, Medway Maritime Hospital, Gillingham, UK.
Open Heart
|June 7, 2019
Summary
Complex cardiac device implantation, including implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT), is commonly performed as a day case procedure in the UK. This approach offers significant cost savings for the NHS.
Area of Science:
- Cardiology
- Health Economics
- Healthcare Management
Background:
- Complex cardiac devices like ICDs and CRT can be safely implanted as day cases.
- Current adoption rates and cost implications of day case procedures require assessment.
Purpose of the Study:
- To determine the prevalence of day case complex cardiac device implantation across the UK.
- To evaluate the potential cost savings associated with wider adoption of day case procedures.
Main Methods:
- A UK-wide freedom of information request was sent to centers performing complex cardiac device implantations.
- Cost analysis utilized the Department of Health National Schedule of Reference Costs 2016-2017.
Main Results:
- 80% of UK centers perform complex cardiac devices as day cases to some extent, with 64% having established protocols.
- Significant cost savings per procedure were identified: £412 (ICD), £525 (CRT-pacemaker), and £2169 (CRT-defibrillator).
- No correlation was found between center volume and the proportion of day case procedures.
Conclusions:
- Day case complex cardiac device implantation is already widespread in the UK.
- Increasing day case procedures to 75% could save the NHS an estimated £5.58 billion annually.
- Further adoption of day case protocols presents a substantial opportunity for healthcare cost reduction.
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