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Document Details :

Title: Cost analysis of minimally invasive compared to conventional mitral valve surgery
Author(s): P. Verbrugghe , H. De Praetere , B. Meuris , F. Rega , B. Meyns , G. Goodall , P. Herijgers
Journal: Acta Cardiologica
Volume: 71    Issue: 5   Date: 2016   
Pages: 527-535
DOI: 10.2143/AC.71.5.3167495

Abstract :
Objective: Minimally invasive cardiac surgery through port-access has been advocated as a valid alternative for conventional full sternotomy approaches. However, the full economic consequences are unclear. We undertook an analysis of our own data to address these uncertainties.
Methods: Retrospective data, on patients who underwent single mitral valve surgery (repair or replacement) were included in our analysis. These were allocated into two cohorts based upon the intended surgical approach: either port-access or full sternotomy. Propensity score matching was performed to avoid confounding factors. Comprehensive clinical and cost data, based on hospital charges and a cost allocation model, were collected.
Results: There were fewer complications with port-access versus full sternotomy. Operation times were longer but there was a shorter intensive care and total hospital stay. Port-access resulted in comparable overall costs (€ 21,041 ± 3,743 compared with € 23,999 ± 15,007 for full sternotomy; mean and standard deviation). A breakdown into accounting groups showed reductions in several costs categories (i.e. nursing costs, technical fees, and pharmacy drugs/implants) except for materials. Patient costs were higher for the port-access group due to higher material costs (€ 1,917 ± 602 versus € 1,145 ± 659; mean and standard deviation). From a hospital perspective direct costs were comparable in both cohorts.
Conclusion: Port-access mitral valve surgery in UZ Leuven has at least comparable short-term clinical results as full sternotomy. It is associated with comparable costs for the acute-treatment phase for the health insurance system and the hospital, but higher patient costs.

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