New England Medical Center,
Tufts University School of Medicine,
Boston, Mass
As the modern treatment of cardiovascular
disorders becomes more and more expensive, greater emphasis will be
placed on cost containment and outcome measures. We are clearly in the
midst of a medical economic revolution as managed-care organizations
make up an increasing portion of third-party payers. In addition, as
the Medicare system confronts future bankruptcy as the baby boomers
become senior citizens, cost containment will become an absolute
necessity. So follows this timely book on the economics of treatment of
cardiovascular disease, edited by a cardiologist (Dr J.
David Talley) and 2 epidemiologists (Drs Patrick D. Mauldin and Edmund
R. Becker).
The first section of the book summarizes current trends in the cost of
managing coronary artery disease. In addition, the authors
discuss changes occurring in the third-party-payer environment and
update modifications in medical reimbursement. Also included is a brief
review outlining the economic principles used in medical cost and
outcome analysis, which provides the reader with a basis for
the methods and data presented throughout the remainder of the
book. The next section reviews strategies for diagnosing
coronary artery disease, discussing both invasive and
noninvasive strategies and which approach is most appropriate from both
a clinical and economic standpoint. Also included is a chapter on
appropriate and cost-effective perioperative risk
stratification in patients with suspected or known coronary
artery disease.
The third and fourth sections review all current data for treatment
strategies and their application to acute and chronic coronary
syndromes, including both medical therapy and invasive
revascularization/treatment strategies. These
© 1998 American Heart Association, Inc.
Book Reviews
Cost Effective Diagnosis and Treatment of Coronary Disease
J. David Talley, MD, Patrick D. Mauldin, PhD, Edmund R. Becker, PhD,eds. J. Willis Hurst, MD, series ed. Topics in ClinicalCardiology. 227 pp. Baltimore, Md: Williams &Wilkins; 1997. $69.00. ISBN 0-683-30302-3.