title: Hospital utilization and costs for spinal cord stimulation compared with enhanced external counterpulsation for refractory angina pectoris.
abstract: OBJECTIVE
  The aim of this study was to compare acute hospital utilization and costs for patients with refractory angina pectoris undergoing spinal cord stimulation (SCS) versus enhanced external counterpulsation (EECP).
  
  
  METHODS
  Seventy-three persons were included in this register study. The acute hospital utilization and costs for SCS and EECP were followed over a period from 12 months before treatment to 24 months after treatment using Patient Administrative Support in Skåne for publicly organized care.
  
  
  RESULTS
  SCS was significantly more expensive than EECP (P < 0.001). Both SCS and EECP entailed fewer days of hospitalization for coronary artery disease in the 12-month follow-up compared with the 12 months preceding treatment. Patients treated with EECP showed an association between reduced hospital admissions and an improved Canadian Cardiovascular Society classification class compared with 1 year before treatment. A significant reduction in cost was seen in both the SCS group (P = 0.018 and P = 0.001, respectively) and the EECP group (P = 0.002 and P = 0.045, respectively) during 12 and 24 months of follow-up compared with before treatment. There were no significant differences between the groups for hospitalization days or admissions, including costs, at the different follow-ups.
  
  
  CONCLUSIONS
  Cost-effective treatment modalities such as SCS and EECP are valuable additions to medical and revascularization therapy in patients with refractory angina pectoris. Pre-existing conditions and the patient's preferences should be taken in consideration when clinicians choose between treatments for this group of patients.
authors: Department of Medicine, Kristianstad University, Kristianstad, Sweden. susanne.bondesson@med.lu.se
authors: Susanne M
authors: SM
authors: Bondesson
authors: Ulf
authors: U
authors: Jakobsson
authors: Lars
authors: L
authors: Edvinsson
authors: Ingalill Rahm
authors: IR
authors: Hallberg
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy / Q000628:therapy*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015908:Counterpulsation / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D062187:Spinal Cord Stimulation / Q000191:economics* / Q000706:statistics & numerical data*
chemical_list: D002317:Cardiovascular Agents