title: [Cost-effectiveness of coronary angioplasty procedures in Poland].
abstract: BACKGROUND
  Restenosis following percutaneous coronary interventions (PCI) increases re-hospitalisation rate and may lead to new myocardial infarction (MI) or death. Besides medical aspects, it may also reduce cost-effectiveness of the procedure.
  
  
  OBJECTIVE
  To analyse the medical and economical outcome of patients treated with PCI during a one year period.
  
  
  METHODS
  Medical outcome, cost of PCI and total cost of treatment during one year after PCI were assessed in 188 consecutive patients who underwent PCI during the first three months of 2002. Patients with acute MI treated with PCI were not included in the analysis.
  
  
  RESULTS
  The rate of major adverse cardiac events (MACE) which included death, new MI or repeated revascularisation, was 1.6% during hospital stay and 14.4% during one-year follow-up. Re-hospitalisation rate was 28.2%. The mean number of outpatient visits during one year was 9.8. The costs of initial hospitalisation and procedures performed during this hospital stay were 7,839 Polish zlotys (PLN) per patient whereas the costs during one-year follow-up were 3,490 PLN (re-hospitalisations and repeated procedures 3,091 PLN, outpatient visits 238 PLN, and pharmacotherapy costs 161 PLN). In the group of patients with MACE, the costs of treatment during one-year follow-up were 13,398 PLN whereas in patients without complications 1,349 PLN per patient.
  
  
  CONCLUSIONS
  Patients who develop complications after PCI generate costs exceeding ten times that of patients with a favourable outcome. Thus, from the economical and medical point of view, there is a need to identify high-risk patients before the decision is made as to which type of treatment is used. Because the health service in Poland is under-funded, patients at risk should be treated with the most effective methods (antiproliferative stents or surgical revascularisation) as an initial treatment, which may decrease total costs during a long-term period.
authors.affiliation: Silesian Center for Heart Diseases, Zabrze, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gasior
authors.forename: Marek
authors.initials: M
authors.lastname: Gierlotka
authors.forename: Urszula
authors.initials: U
authors.lastname: Gasior
authors.forename: Piotr
authors.initials: P
authors.lastname: Chodór
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lekston
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Klosa
authors.forename: Janusz
authors.initials: J
authors.lastname: Balcarek
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kalarus
authors.forename: Lech
authors.initials: L
authors.lastname: Poloński
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000191:economics*; D001026:Coronary Artery Bypass / Q000191:economics*; D003327:Coronary Disease / Q000191:economics* / Q000628:therapy*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics; D011044:Poland; D012086:Reoperation / Q000191:economics