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Cost and health out...
Cost and health outcome of primary percutaneous coronary intervention versus thrombolysis in acute ST-segment elevation myocardial infarction-Results of the Swedish Early Decision reperfusion Study (SWEDES) trial.
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- Aasa, Mikael (författare)
- Karolinska Institutet,Karolinska Institute
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- Henriksson, Martin (författare)
- Linköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet
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- Dellborg, Mikael, 1954 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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- Grip, Lars, 1952 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Herlitz, Johan, 1949 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,[external]
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- Levin, Lars-Åke, 1960 (författare)
- Linköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet
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- Svensson, Leif (författare)
- Karolinska Institutet,Stockholm Prehospital Centre
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- Janzon, Magnus (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken
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(creator_code:org_t)
- Elsevier BV, 2010
- 2010
- Engelska.
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Ingår i: American heart journal. - : Elsevier BV. - 1097-6744 .- 0002-8703. ; 160:2, s. 322-8
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- BACKGROUND: In ST-elevation myocardial infarction, primary percutaneous coronary intervention (PCI) has a superior clinical outcome, but it may increase costs in comparison to thrombolysis. The aim of the study was to compare costs, clinical outcome, and quality-adjusted survival between primary PCI and thrombolysis. METHODS: Patients with ST-elevation myocardial infarction were randomized to primary PCI with adjunctive enoxaparin and abciximab (n = 101), or to enoxaparin followed by reteplase (n = 104). Data on the use of health care resources, work loss, and health-related quality of life were collected during a 1-year period. Cost-effectiveness was determined by comparing costs and quality-adjusted survival. The joint distribution of incremental costs and quality-adjusted survival was analyzed using a nonparametric bootstrap approach. RESULTS: Clinical outcome did not differ significantly between the groups. Compared with the group treated with thrombolysis, the cost of interventions was higher in the PCI-treated group ($4,602 vs $3,807; P = .047), as well as the cost of drugs ($1,309 vs $1,202; P = .001), whereas the cost of hospitalization was lower ($7,344 vs $9,278; P = .025). The cost of investigations, outpatient care, and loss of production did not differ significantly between the 2 treatment arms. Total cost and quality-adjusted survival were $25,315 and 0.759 vs $27,819 and 0.728 (both not significant) for the primary PCI and thrombolysis groups, respectively. Based on the 1-year follow-up, bootstrap analysis revealed that in 80%, 88%, and 89% of the replications, the cost per health outcome gained for PCI will be <$0, $50,000, and $100,000 respectively. CONCLUSION: In a 1-year perspective, there was a tendency toward lower costs and better health outcome after primary PCI, resulting in costs for PCI in comparison to thrombolysis that will be below the conventional threshold for cost-effectiveness in 88% of bootstrap replications.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)
Nyckelord
- Aged
- Angioplasty
- Transluminal
- Percutaneous Coronary
- economics
- Cost-Benefit Analysis
- Female
- Hospitalization
- economics
- Humans
- Male
- Middle Aged
- Myocardial Infarction
- drug therapy
- economics
- mortality
- therapy
- Myocardial Reperfusion
- Outcome Assessment (Health Care)
- Quality of Life
- Sweden
- Thrombolytic Therapy
- economics
- MEDICINE
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Aasa, Mikael
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Henriksson, Mart ...
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Dellborg, Mikael ...
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Grip, Lars, 1952
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Herlitz, Johan, ...
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Levin, Lars-Åke, ...
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visa fler...
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Svensson, Leif
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Janzon, Magnus
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- Om ämnet
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Dermatologi och ...
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American heart j ...
- Av lärosätet
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Göteborgs universitet
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Karolinska Institutet
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Högskolan i Borås
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Linköpings universitet