title: In-hospital cost comparison between percutaneous pulmonary valve implantation and surgery.
abstract: Today, both surgical and percutaneous techniques are available for pulmonary valve implantation in patients with right ventricle outflow tract obstruction or insufficiency. In this controlled, non-randomized study the hospital costs per patient of the two treatment options were identified and compared.
  
  
  
  During the period of June 2011 until October 2014 cost data in 20 patients treated with the percutaneous technique and 14 patients treated with open surgery were consecutively included. Two methods for cost analysis were used, a retrospective average cost estimate (overhead costs) and a direct prospective detailed cost acquisition related to each individual patient (patient-specific costs).
  
  
  
  The equipment cost, particularly the stents and valve itself was by far the main cost-driving factor in the percutaneous pulmonary valve group, representing 96% of the direct costs, whereas in the open surgery group the main costs derived from the postoperative care and particularly the stay in the intensive care department. The device-related cost in this group represented 13.5% of the direct costs. Length-of-stay-related costs in the percutaneous group were mean $3885 (1618) and mean $17 848 (5060) in the open surgery group. The difference in postoperative stay between the groups was statistically significant ( P ≤ 0.001).
  
  
  
  Given the high postoperative cost in open surgery, the percutaneous procedure could be cost saving even with a device cost of more than five times the cost of the surgical device.
authors.affiliation: The Intervention Centre, Oslo University Hospital, Oslo, Norway.|Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Brith
authors.initials: B
authors.lastname: Andresen
authors.affiliation: Department of Finance and Resource Management Unit, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Vinod
authors.initials: V
authors.lastname: Mishra
authors.affiliation: The Intervention Centre, Oslo University Hospital, Oslo, Norway.
authors.forename: Milena
authors.initials: M
authors.lastname: Lewandowska
authors.affiliation: Division of Radiology and Nuclear Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Jack Gunnar
authors.initials: JG
authors.lastname: Andersen
authors.affiliation: Division of Surgery, Inflammation Medicine and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Marit Helen
authors.initials: MH
authors.lastname: Andersen
authors.affiliation: Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Harald
authors.initials: H
authors.lastname: Lindberg
authors.affiliation: Department of Pediatric Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Gaute
authors.initials: G
authors.lastname: Døhlen
authors.affiliation: The Intervention Centre, Oslo University Hospital, Oslo, Norway.|Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Fosse
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003422:Critical Care / Q000191:economics / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis / Q000191:economics; D019918:Heart Valve Prosthesis Implantation / Q000191:economics* / Q000295:instrumentation / Q000379:methods*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000379:methods; D009664:Norway; D011182:Postoperative Care / Q000191:economics / Q000379:methods; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000191:economics / Q000601:surgery; D014694:Ventricular Outflow Obstruction / Q000191:economics / Q000601:surgery; D055815:Young Adult
keywords: Congenital pulmonary heart disease; Cost analysis; In-hospital costs; Innovative techniques