Differences in episode-based care costs for multidetector computed tomographic coronary angiography versus myocardial perfusion imaging for the diagnosis of coronary artery disease.
BACKGROUND
Multidetector computed tomography (MDCT) is a novel method for diagnosis and prognosis of coronary artery disease (CAD). The opportunity costs that favour MDCT over other CAD diagnostic methods is currently unknown.


METHODS
This study used an episodes of care cost model based on epidemiologic and economic data evaluating individuals without known CAD undergoing MDCT or myocardial perfusion scintigraphy (MPS). It was a multicenter retrospective database review of medical and pharmacy-related claims linked by episodes of care from 2002 to 2005. CAD-related episodes of care costs were examined 1-year downstream for patients after initial MDCT that were matched to patients who underwent MPS.


RESULTS
After adjustment for patient factors, 1-year total CAD-related episodes of care costs for MDCT were 16.4% lower than MPS, by an average of $682 (95% confidence interval $14, $1,350) per patient. While costs per CAD-related episode were similar between MDCT and MPS groups ($4,284 vs. $4,277, p=0.08).


CONCLUSIONS
Patients without known CAD who undergo MDCT as an initial diagnostic test, compared to MPS, incurred fewer CAD-related episodes of care and lower overall CAD-related costs.
Min
James K
JK
The Greenberg Division of Cardiology, Weill Medical College of Cornell University, The New York Presbyterian Hospital, New York, NY 10021, USA. jkm2001@med.cornell.edu
Robinson
Matthew
M
Shaw
Leslee J
LJ
Lin
Fay
F
Legorreta
Antonio P
AP
Gilmore
Amanda
A
D015897:Comorbidity; D017023:Coronary Angiography / Q000191:economics*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003326:Coronary Circulation; D003952:Diagnostic Imaging / Q000191:economics; D017050:Episode of Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000191:economics*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods*