The comparison of the clinical outcomes and costs between surgical aortic valve replacement and transcatheter aortic valve implantation based on the Japanese Diagnosis Procedure Combination database

© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd..

PURPOSE: We evaluated the clinical outcomes and costs of surgical aortic valve replacement (SAVR) and transfemoral transcatheter aortic valve implantation (TAVI) for aortic stenosis using the Japanese Diagnosis Procedure Combination (DPC) database.

METHODS: Using our extraction protocol, we retrospectively analyzed summary tables in the DPC database from 2016 to 2019, which were provided by the Ministry of Health, Labor and Welfare. A total of 27,278 patients were available (SAVR, n = 12,534; TAVI, n = 14,744).

RESULTS: The TAVI group was older than the SAVR group (SAVR vs. TAVI: 74.6 vs. 84.5 years; P < 0.01), with a lower in-hospital mortality (1.0 vs. 0.6%; P < 0.01) and a shorter hospital stay (26.9 vs. 20.3 days; P < 0.01). TAVI conferred more total medical service reimbursement points than SAVR (493,944 vs. 605,241 points; P < 0.01), especially materials points (147,830 vs. 434,609 points; P < 0.01). Total insurance claims for TAVI were approximately 1 million yen higher than those for SAVR. Regarding the details of costs, only the operation cost was higher, while other costs were lower with TAVI than with SAVR.

CONCLUSION: Our analysis revealed that both SAVR and TAVI showed acceptable clinical outcomes. TAVI was associated with higher total insurance claims than SAVR. If the material cost of TAVI operations can be reduced, greater cost-effectiveness can be expected.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:54

Enthalten in:

Surgery today - 54(2024), 3 vom: 01. März, Seite 240-246

Sprache:

Englisch

Beteiligte Personen:

Yunoki, Junji [VerfasserIn]
Morita, Shigeki [VerfasserIn]
Hayashi, Nagi [VerfasserIn]
Jinnouchi, Kouki [VerfasserIn]
Morokuma, Hiroyuki [VerfasserIn]
Itoh, Manabu [VerfasserIn]
Kamohara, Keiji [VerfasserIn]

Links:

Volltext

Themen:

Cost
Diagnosis Procedure Combination
Journal Article
Surgical aortic valve replacement
Transcatheter aortic valve implantation
Transcatheter aortic valve replacement

Anmerkungen:

Date Completed 20.02.2024

Date Revised 04.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00595-023-02722-9

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM358970040