The evolving costs of intracoronary stents.
BACKGROUND
As stenting practice has evolved to include greater numbers of stents and adjunctive balloon catheters per case, concern has focused on the increasing costs of equipment for the delivery of stents.


RESULTS
To evaluate temporal changes in costs of intracoronary stenting, we examined total costs, catheterization laboratory equipment costs, equipment utilization, and nonlaboratory hospital costs for stent cases for two time periods: Period I (n = 46; 3 months in 1995 involving routine warfarin anticoagulation) and Period II (n = 129; 4 months during which warfarin was being abandoned). Overall costs declined from Period I ($11,293+/-$7672) to Period II ($9819+/-$3636) (p = 0.074). Catheterization laboratory equipment expenditures rose (Period I, $3823+/-$1394 vs Period II, $4278+/-$1533), whereas noncatheterization laboratory hospital costs declined significantly (Period I, $7281+/-$7179 vs Period II, $5560+/-$3420). The difference in costs was most notable when taking into account the deletion of warfarin anticoagulation. Costs declined by $2428 for patients in Period II in whom warfarin was not prescribed (p < 0.05 vs patients in Period I).


CONCLUSIONS
We conclude that despite the increasing costs for equipment of stent cases, our overall costs of providing stents declined as warfarin anticoagulation was abandoned.
University of Vermont College of Medicine, University of Vermont School of Business Administration, and Budget and Reimbursement, Fletcher Allen Health Care, Burlington, USA.
P T
PT
Vaitkus
C
C
Adele
S K
SK
Wells
J P
JP
Zehnacker
D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000191:economics / Q000295:instrumentation; D016507:Cardiology Service, Hospital / Q000191:economics*; D003327:Coronary Disease / Q000188:drug therapy / Q000191:economics / Q000601:surgery; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000191:economics*; D014707:Vermont; D014859:Warfarin / Q000191:economics / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin