Hospital cost of endovascular versus open repair of abdominal aortic aneurysms: A multicenter study

Sternbergh, W. C. and Money, S. R. (2000) Hospital cost of endovascular versus open repair of abdominal aortic aneurysms: A multicenter study. Journal of Vascular Surgery, 31 2: 237-244. doi:10.1016/S0741-5214(00)90154-X

Author Sternbergh, W. C.
Money, S. R.
Title Hospital cost of endovascular versus open repair of abdominal aortic aneurysms: A multicenter study
Journal name Journal of Vascular Surgery   Check publisher's open access policy
ISSN 0741-5214
Publication date 2000-02-01
Sub-type Article (original research)
DOI 10.1016/S0741-5214(00)90154-X
Volume 31
Issue 2
Start page 237
End page 244
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Formatted abstract
Background: Technology-driven innovation in medicine is frequently associated with higher costs than conventional therapy. A significantly higher cost for endovascular ($21,250, n = 190) versus open abdominal aortic aneurysm (AAA) repair ($12,342, n = 60) was suggested by a direct cost analysis of patients in a multicenter trial. Estimated inpatient costs (not charges) incurred nationwide by hospitals for endovascular and open repair of AAA were studied to validate these observed trends.

Methods: A retrospective analysis of 131 patients undergoing endovascular AAA. repair was compared with 49 patients undergoing open repair as part of a Food and Drug Administration phase II prospective multicenter clinical investigation (AneuRx-Medtronic). A model to estimate costs was constructed using important clinical descriptors of these patients. These clinical characteristics where then matched with those from 22,460 patients undergoing AAA repair obtained from a large national database (Medicare Provider Analysis and Review). Estimated hospital cost was then assigned to each study patient according to the national average of the:total hospital costs for the respective matched patients in Medicare Provider Analysis and Review.

Results: Total inpatient hospital costs of endovascular, repair were significantly higher than that of open repair ($19,985 +/- 7396 versus $12,546 +/- 5944, respectively, P = .0001). Endograft device cost ($10,400) accounted for 52% of the total cost of endovascular repair. The 1999 mean blended Medicare reimbursement for AAA repair was $18,989.

Conclusion: In this early development stage, hospital cost for endovascular AAA repair is significantly greater than open repair when device cost greatly exceeds $5000. Although incremental reductions in cost of endovascular repair may be anticipated if use of diagnostic studies, operating time, and length of stay decrease, device cost has the single greatest impact on the expense of endovascular AAA repair. At current device pricing, mean blended Medicare reimbursement does:ndt cover the cost of endovascular AAA repair.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 86 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 14 Mar 2011, 20:04:59 EST