February 3, 2015 — Coronary bypass graft surgery commonly used to treat patients with coronary heart disease results in improved quality of life but also costs more than another often-used less invasive technique, Christiana Care Health System researchers reported in January in the Journal of the American College of Cardiology.
Known as the ASCERT (American College of Cardiology Foundation–The Society of Thoracic Surgeons Collaboration on the Comparative Effectiveness of Revascularization Strategies) study, this research represents the first of its kind nationwide to evaluate and compare hundreds of thousands of clinical and claims data to determine both the survival benefit and overall costs of coronary artery bypass graft compared to percutaneous coronary intervention, another common surgical procedure that is also referred to as angioplasty.
The study found that patients who underwent bypass graft surgery lived longer and were able to function better and had less additional procedures than those treated with angioplasty. Researchers drew their conclusions by analyzing a widely-accepted metric known as quality-adjusted life-years.
“While other studies have compared the costs of the two types of treatment, we wanted to probe deeper to understand the value of these procedures to patients,” said Zugui Zhang, Ph.D., a senior biostatistician and scholar at Christiana Care’s Value Institute, and lead author in the study. “Although the grafting procedure costs more, we also found that patients who underwent that procedure lived longer and had fewer additional procedures.”
Over a four-year period, the study looked at people 65 years or older with coronary heart disease in two or three of their heart vessels.
In addition to the quality of life metrics, researchers found the grafting procedure also resulted in higher costs per patient than angioplasty in three areas:
- Hospitalization was on average $10,670 more.
- Clinical care after the surgery was on average $8,145 more.
- Lifetime projected costs after the surgery were on average $11,575 more.
“Coronary heart disease affects so many of our neighbors, so our hope is to provide patients and their families with knowledge so they can make informed decisions on their health care,” Zhang said. “Through this study, we have found that coronary artery bypass grafts provide a reasonably better value to patients when compared to angioplasties.”
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