Economic burden of coronary artery bypass grafting surgery on government and patients: a two-center study

The objective of this cost-of-illness study was to determine the direct medical costs associated with coronary artery bypass grafting (CABG) procedures from both governmental (Ministry of Health) and patient (private sector) perspectives within the context of hospitalization.

This prospective study was conducted on patients who underwent CABG at two cardiac surgical centers in Baghdad, Iraq: a public and a private hospital. Data were collected from January through July 2024. In the public ward, direct medical costs (DMCs) were extracted from patients' medical records, healthcare providers, and hospital administration. In the private ward/hospital, DMCs were extracted from hospital bills. The cost of the CABG procedure was measured as the cost of the entire hospital admission during which the surgery was performed.

The study included 90 patients. Among these patients, 30 were admitted to each of the public ward, private ward, and private hospital. For patients in the public ward, the average cost of CABG during hospitalization was $4,712.89 per patient. For patients admitted to the private ward, the average charges were $3,963 while the actual average cost was $4,504 per patient. On average, each patient paid $9,461 to the private hospital for CABG hospitalization. Finally, in the public ward, CABG materials were the highest cost component (35%) of total expenditure, followed by surgical team labor cost (26%) and hospitalization costs (13.8%).

Despite patients paying charges for CABG in the private ward in the government hospital, the Ministry of Health continues to provide subsidized prices to lower the actual costs. The charges of CABG in the private hospital were double the actual costs of the public ward since it imposes profit. Finally, the study methodologies can be adopted by any country operating under the Beveridge Model or out-of-pocket health systems.