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Prevalence, Outcomes and Cost Implications of Patients Undergoing Same Day Discharge After Elective Percutaneous

Stephanie Liew1, Diem Dinh2, Danny Liew2

  • 1Department of Cardiovascular Medicine, The Alfred Hospital, Melbourne, Vic, Australia.

Heart, Lung & Circulation
|December 4, 2019
PubMed

Insights

Same day discharge (SDD) after elective percutaneous coronary intervention (PCI) is safe and feasible in Australia, despite infrequent use. SDD reduces hospital stay and costs, improving overall PCI care value.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Health Services Research

Background:

  • Same day discharge (SDD) following percutaneous coronary intervention (PCI) is growing internationally but underutilized.
  • This study investigated the prevalence, outcomes, and costs of SDD in Australian elective PCI patients.

Purpose of the Study:

  • To determine the incidence and clinical outcomes of SDD versus overnight observation (ON) after elective PCI.
  • To assess the cost implications and hospital variation associated with SDD.

Main Methods:

  • Retrospective observational cohort study of 18,101 elective PCI patients in Victoria (2014-2017).
  • Data sourced from the Victorian Cardiac Outcomes Registry (VCOR).
  • Propensity score matching compared 30-day major adverse cardiac events (MACE), complications, and readmissions between SDD and ON groups.

Main Results:

  • SDD rate was low (3.2%), with significant hospital variation (0-16.6%).
  • SDD was non-inferior to ON for 30-day MACE (0.5% vs. 11.6% unplanned readmission).
  • SDD reduced average length of stay by 2.06 days, improving cost-effectiveness.

Conclusions:

  • Same day discharge after elective PCI is safe and feasible in Australia.
  • Increased adoption of SDD could enhance the value and efficiency of PCI care.
  • Addressing hospital variation in SDD rates is crucial for wider implementation.
Abstract

Keywords:
Coronary interventionLength of staySame Day PCI

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