Abstract 16095: Inpatient and Outpatient Resource Utilization in the Evaluation and Management of Patients With Aortic Stenosis Being Considered for Transcatheter Aortic Valve Replacement (TAVR)
Introduction: The evaluation and treatment of patients with aortic stenosis (AS) being considered for TAVR often requires a significant utilization of medical resources at a substantial cost. In a healthcare environment of limited resources and a growing population eligible for TAVR, a better understanding of these costs is needed.
Methods: Patients with aortic stenosis evaluated at Duke University Medical Center between 12/2010 and 12/2011 were identified using ICD-9 diagnosis codes. A detailed chart review of these patients was performed to identify those seen in consideration for TAVR. All inpatient and outpatient costs incurred by these patients at Duke from their initial TAVR evaluation through April 2012 were collected and analyzed.
Results: A total of 1586 unique patients were seen at Duke for AS during the study period, with 219 of these seen in consideration for TAVR. Their average age was 80 (10) years, 107 (49%) were male, and 194 (89%) were Caucasian. The mean follow-up time per patient was 288 (142) days. Table 1 lists the average number of inpatient and outpatient encounters, use of various cardiac procedures, and their associated costs, displayed according to AS treatment strategy. Those undergoing TAVR had the highest total average cost per patient of $84,471, followed by surgical AVR ($55,037), balloon aortic valvuloplasty (BAV) ($45,085), and medical therapy alone ($10,814). TAVR patients had the highest use of CTA, echocardiography, and pacemakers. The majority of the cost for TAVR patients was driven by higher treatment and procedural costs ($64,822) compared with the other 3 treatment groups.
Conclusions: Among patients with aortic stenosis being evaluated for TAVR, substantial medical and financial resources are consumed in the care of these patients, with TAVR being the most expensive therapy. As the number of patients with severe AS continues to grow, understanding the drivers of these costs may facilitate more efficient delivery of care.
- Transcatheter Aortic Valve Implantation
- Aortic stenosis
- Interventional cardiology
- © 2013 by American Heart Association, Inc.