Improving cost and outcome of coronary surgery

Area of Science:

• Cardiovascular Surgery
• Health Economics

Background:

• Increasing interest in improving outcomes and reducing costs for coronary artery bypass grafting (CABG).
• Need to evaluate changes in CABG outcomes and associated costs over time.

Purpose of the Study:

• To determine changes in the outcome and cost of CABG between 1988 and 1996.
• To assess the impact of evolving patient demographics and disease severity on CABG results.

Main Methods:

• Evaluation of clinical and financial data for 12,266 patients undergoing CABG.
• Data sourced from Emory Cardiovascular Database and UB92 hospital bill formulation.
• Costs adjusted for inflation and severity of illness indexes.

Main Results:

• Despite patients becoming sicker (increased comorbidities), mortality rates significantly decreased (OR, 0.90/y; P = 0.0001).
• Q-wave myocardial infarction rates fell from 4.1% to 1.3% (P < 0.0001).
• Mean hospital cost decreased by $1118 per year, and length of stay reduced by 0.55 days annually.

Conclusions:

• Coronary artery bypass grafting outcomes have improved, marked by reduced mortality and Q-wave myocardial infarctions.
• These improvements were achieved concurrently with decreased healthcare costs and shorter hospital stays.
• Future trends in CABG outcomes and costs warrant continued observation.