The impact of medical technology on health: a longitudinal analysis of ischemic heart disease.
OBJECTIVE
This article estimates the costs and benefits of changes in ischemic heart disease (IHD) care in Spain from 1980 to 2003.


METHODS
We use joinpoint regression to identify trends in the standardized rates of mortality and hospitalization for IHD in general and acute myocardial infarction (AMI) in particular. We estimate also logistic regression models for the probability of in-hospital death of patients admitted for AMI. To measure costs and benefits between 1980 and 2003 we use the microdata from Spanish Hospital Morbidity Survey, and the reports of the Cardiac Catheterization and Coronary Intervention Registry of the Spanish Society of Cardiology.


RESULTS
Mortality from IHD in Spain has been substantially reduced in the past 25 years. Medical advances have saved lives of many patients admitted to hospitals. If the patients with AMI admitted in 2003 had been treated with 1980 procedures the rate of hospital mortality for AMI would have doubled. The estimated benefits in 2003 are the lives of the 5326 patients saved. The unit real costs have increased from euro2143 to euro4550 per AMI admission. If this cost increase is applied to the 57,842 Spanish AMI inpatients admitted in 2003, one could say that advances in medical technology from 1980 to 2003 carry a cost of euro26,140 per life saved.


CONCLUSIONS
In Spain advances in hospital technology for the treatment of IHD since 1980 are well worth the cost.
López-Valcárcel
Beatriz G
BG
University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. bvalcarcel@dmc.ulpgc.es
Pinilla
Jaime
J
D020811:Biomedical Technology / Q000191:economics*; D005260:Female; D006302:Health Services Research; D017721:Hospital Costs; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008017:Life Expectancy; D016015:Logistic Models; D008297:Male; D017059:Models, Econometric; D017202:Myocardial Ischemia / Q000191:economics / Q000401:mortality* / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013030:Spain / Q000453:epidemiology; D013997:Time Factors