A strategy for cost containment in coronary surgery.

Area of Science:

• Cardiovascular Surgery
• Health Economics
• Patient Care Management

Background:

• Coronary artery bypass grafting (CABG) traditionally involves pre-operative hospitalization.
• Multivessel coronary atherosclerosis and stable angina pectoris represent common indications for CABG.
• Optimizing patient pathways and reducing healthcare costs are significant challenges in cardiac surgery.

Purpose of the Study:

• To evaluate the impact of an outpatient pre-surgical preparation model on hospital charges and length of stay for CABG patients.
• To compare the cost-effectiveness of pre-operative outpatient staging versus traditional inpatient admission.
• To assess patient preference for pre-operative care settings.

Main Methods:

• An experimental group of patients with stable angina underwent outpatient testing and pre-operative staging at home with families before CABG.
• Hospital charges and length of stay were compared with historical control groups admitted conventionally.
• Inflation-adjusted financial data and patient interviews were utilized for comprehensive analysis.

Main Results:

• The experimental group experienced a reduction of two days in hospital length of stay.
• A 10% overall saving in hospital charges was observed in the 2021 experimental group compared to the 2021 control group.
• Inflation-adjusted analysis revealed significant cost reductions: 35% less for hospital room, 45% less for intensive care, and 17% less in total charges compared to the 1977 control group.

Conclusions:

• An outpatient pre-surgical staging model for coronary bypass surgery is a viable and cost-effective alternative to traditional inpatient admission.
• This approach not only reduces healthcare expenditures but also aligns with patient preferences for pre-operative care.
• Implementing such models can lead to substantial savings in hospital resources and improve patient satisfaction.