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Comparative analysis of cardiac surgical outcomes across different healthcare funding modalities: a comprehensive
Sufina Shales1, Paramita Auddya Ghorai1, Bharath Sundar1
1Department of Cardiac Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Narayana Health, 124, EM Bypass, Mukundapur, Kolkata, 700099 India.
Insights
Cardiac surgery outcomes are similar across all payment types, including government schemes. This study found no significant differences in mortality rates, demonstrating equitable care regardless of funding source for cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Health Economics
- Health Services Research
Background:
- Patient outcomes in cardiac surgery can be influenced by socioeconomic factors and healthcare access.
- Perceptions often suggest disparities in care quality based on funding mechanisms, particularly for government-sponsored health programs.
Purpose of the Study:
- To critically examine patient outcomes across different funding categories in cardiac surgical interventions.
- To assess if healthcare financing models impact mortality rates in major cardiac surgeries.
Main Methods:
- A retrospective cohort analysis of cardiac surgery patients (April 2017-August 2023) at a single institution.
- Patients were stratified into six funding categories: Cash Payment, Insurance, Government Schemes, Fund/Trust, Public Sector Unit, and Swasthya Sathi.
- Mortality rates were analyzed for isolated coronary artery bypass grafting (CABG), aortic valve replacement, and mitral valve replacement.
Main Results:
- The overall mortality rate was 2.40%, with no statistically significant differences observed across the six funding categories (p=0.74).
- Mortality rates for individual procedures (aortic valve replacement, mitral valve replacement, isolated CABG) were comparable across all funding sources.
- Government scheme patients showed no significant difference in mortality compared to cash-paying patients for specific procedures.
Conclusions:
- Funding mechanisms do not significantly impact surgical outcomes in this cardiac surgery cohort.
- Preliminary evidence challenges perceptions of inferior care for government-funded patients, suggesting equitable medical care delivery.
- Diverse healthcare financing models can potentially provide effective and equitable cardiac surgical care.
Aim:
To critically examine patient outcomes across different funding categories in cardiac surgical interventions.
Methods:
A retrospective cohort analysis was conducted on patients undergoing cardiac surgery between April 2017 and August 2023 at a single institution. Patients were stratified into six distinct funding categories: Cash Payment, Insurance, Government Schemes, Fund/Trust, Public Sector Unit, and the state-specific Swasthya Sathi patients. We examined three major surgical procedures: isolated coronary artery bypass grafting (CABG), aortic valve replacement, and mitral valve replacement. The primary outcome was mortality rates across various funding schemes and specific surgical procedures.
Results:
The overall mortality rate was 2.40%, with no statistically significant differences observed across funding categories (p = 0.74). Mortality rates for individual procedures were also comparable across funding sources: aortic valve replacement (p = 0.70), mitral valve replacement (p = 0.11), and isolated CABG (p = 0.68). Specifically, when comparing government scheme patients to cash-paying patients, no significant differences were found for aortic valve replacement (p = 0.65), mitral valve replacement (p = 0.53), or isolated CABG (p = 0.45). Among patients covered under West Bengal's state-sponsored Swasthya Sathi scheme, the mortality rate was 2.2%, compared to 2.7% in non-Swasthya Sathi patients (p = 0.47).
Conclusion:
Our study provides preliminary evidence that challenges the widespread perception of inferior care for government-funded patients. The study suggests that the funding mechanism does not significantly impact surgical outcomes in this cardiac surgery cohort, highlighting the potential effectiveness of diverse healthcare financing models in delivering equitable medical care.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s12055-025-01987-8.
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