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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Breaking down the silos: Transcatheter aortic valve implant versus open heart surgery
1549576Medtronic of Canada Ltd., Brampton, Ontario, Canada.
Insights
Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) have comparable hospital costs. Full-cost accounting reveals TAVI
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Hospital Administration
Background:
- Hospital budget silos hinder innovative clinical practices.
- Budget fluidity supports initiatives aligning with the Quadruple Aim.
- Aortic stenosis management involves Surgical Aortic Valve Replacement (SAVR) and Transcatheter Valve Implantation (TAVI).
Purpose of the Study:
- To calculate the budget impact of SAVR versus TAVI in high-risk aortic stenosis.
- To demonstrate the value of a full-cost accounting approach in healthcare budgeting.
- To compare the total cost of care between SAVR and TAVI over one year.
Main Methods:
- Full-cost accounting analysis.
- Budget impact calculation comparing SAVR and TAVI.
- Scenario analysis of patient cohort cost variations.
Main Results:
- TAVI had a higher upfront budget impact ($52,576) than SAVR ($48,578).
- SAVR adverse event management costs were higher ($17,718) than TAVI ($11,754) over one year.
- Total care costs for a cohort of 100 patients were comparable between baseline (70% SAVR/30% TAVI) and future (30% SAVR/70% TAVI) scenarios.
Conclusions:
- Despite higher initial costs, TAVI's overall hospital budget impact is comparable to SAVR when considering full costs.
- A full-cost accounting approach is crucial for evaluating innovative procedures like TAVI within hospital financial structures.
- Budget fluidity and comprehensive cost analysis can facilitate the adoption of cost-effective, high-value treatments.
Abstract:
Budget silos innate to hospital global funding schemes tend to inhibit the adoption of innovative clinical practices. In contrast, budget fluidity can encourage initiatives that align with the Quadruple Aim. This article calculated the budget impact of Surgical Aortic Valve Replacement (SAVR) and Transcatheter Valve Implant (TAVI) in high-risk aortic stenosis to demonstrate the value of a full-cost accounting approach. The budget impact of TAVI was $4,000 more than SAVR ($52,576 vs $48,578). However, the cost of managing SAVR adverse events was higher than TAVI ($17,718 vs. $11,754) over 1 year. A scenario analysis demonstrated that the total cost of care for a cohort of 100 patients at baseline ratio of 30% TAVI versus 70% SAVR was similar to a future scenario, with reverse proportions. While TAVI may seem expensive upfront, when considered as a surgical department budget item, the overall cost to the hospital is comparable to the SAVR.
