[Hemodynamic and coronary angiographic performance at a center with medium-low activity: organization model, activity indicators, and costs].
BACKGROUND
In order to evaluate the cost-effectiveness of coronary angiography performed in a low volume Center, we examined our 1-year activity.


METHODS
The organizational model of the multipurpose cardiac catheterization laboratory is described. In this type of facility both coronary angiographic and electrophysiological studies are performed. To evaluate the laboratory performance we examined the utilization level, the appropriateness of the studies, the complication rates and the number of studies that had to be repeated because of inadequate data or image quality. The costs were calculated for the in-house laboratory setting (the actual scenario) and for the 25 km distant laboratory setting (the historical scenario).


RESULTS
The laboratory caseload of coronary angiography was 342 studies, 46% of the overall laboratory activity; 175 patients (51%) underwent non-pharmacological therapy, 129 patients (38%) were treated with medical therapy; the percentage of patients with normal coronary arteries was 11%. Two patients (0.58%) had vascular complications, 1 patient (0.29%) developed an acute myocardial infarction 2 hours after coronary angiography without any evidence of angiographic modifications at the repeated study. In no patient the study had to be repeated because of inadequate data or image quality. The mean cost of a coronary angiography was Lit. 512,000 (265 Euro) for the actual scenario; it would have been Lit. 694,000 (359 Euro) for the historical scenario, with Lit. 182,000 (94 Euro) saved.


CONCLUSIONS
These findings are consistent with the accepted criteria of good laboratory performance and cost-effectiveness. Thus coronary angiography can be performed effectively and efficiently in a low volume Center.
Vergara
G
G
Azienda Provinciale per i Servizi Sanitari del Trentino, Unità Operativa di Cardiologia, Ospedale S. Maria del Carmine, Rovereto, TN. vergara@rov.aziendasanitaria.trentino.it
Accardi
R
R
Imperadore
F
F
Catanzariti
D
D
Cozzi
F
F
Bonadies
D
D
Morani
G
G
Spagnolli
W
W
Della Mea
M T
MT
Girardini
D
D
Ferro
A
A
D002300:Cardiac Care Facilities / Q000191:economics* / Q000458:organization & administration*; D017023:Coronary Angiography; D003365:Costs and Cost Analysis; D006334:Heart Function Tests / Q000191:economics*; D006439:Hemodynamics; D006801:Humans; D007558:Italy