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Normal coronary angiograms: financial victory from the brink of clinical defeat?
B Keavney1, Y M Haider, A J McCance
1Department of Cardiology, Glenfield General Hospital, Leicester, United Kingdom.
Insights
Patients with suspected ischemic heart disease who have normal coronary angiography results show a significant decrease in healthcare resource consumption afterward. Early investigation is safe and cost-effective in the medium term.
Area of Science:
- Cardiology
- Health Economics
Background:
- Patients with suspected ischemic heart disease often undergo coronary angiography.
- Normal angiographic results in these patients can lead to continued high healthcare resource consumption.
Purpose of the Study:
- To test if normal coronary angiography results correlate with reduced healthcare resource use.
- To evaluate the economic impact of early investigation for suspected coronary atherosclerosis.
Main Methods:
- A retrospective cost-benefit analysis was conducted.
- Compared 12-month periods before and after coronary angiography in 69 patients with normal results.
- Assessed drug costs, hospital admissions, and general practitioner consultations.
Main Results:
- Mean annual healthcare cost per patient before angiography was £656.89.
- A significant reduction in resource consumption was observed post-angiography.
- Mean monthly cost reduction was £35.15, with angiography costs recouped in 18 months.
Conclusions:
- Patients with normal coronary arteries after angiography are significant healthcare consumers.
- Early coronary angiography for suspected coronary atherosclerosis is safe.
- Investigation yields beneficial medium-term resource consequences.
Objective:
To examine the hypothesis that, in patients undergoing coronary angiography for suspected ischaemic heart disease, a normal angiographic result is associated with a fall in consumption of health care resources following the angiogram.
Design:
Retrospective cost-benefit analysis comparing the 12 month periods before and after coronary angiography.
Setting:
Tertiary cardiac referral centre.
Subjects:
69 consecutive patients investigated in the financial year 1991-92 whose angiograms were normal.
Main Outcome Measures:
Drug and hospital admission costs in the 12 month periods before and after angiography; urgent and elective consultations with general practitioner in that time.
Results:
The mean cost of care per patient in the year before investigation was 656.89 pounds. A highly significant fall in all indices of resource consumption was observed in the year following investigation, the mean resulting difference in the cost of care being 35.15 pounds per month. The cost of coronary angiography would, if this fall were maintained, be recouped in a mean time of 18 months.
Conclusions:
Patients suspected on clinical grounds to have coronary atherosclerosis who are found at angiography to have normal coronary arteries are heavy consumers of health care resources. Early investigation for these patients is safe and has beneficial resource consequences in the medium term.