Abstract 18213: Efficacious Lymphedema Treatment: Impact of an Advanced Pneumatic Compression Device on Health Outcomes and Costs
Introduction: Lymphedema (LE) is a common cardiovascular disease (CVD) that impairs quality of life and increases adverse clinical events and costs. LE is common in individuals with cancer undergoing treatment. Physical therapy, bandaging, compressive garments, and pneumatic compression devices (PCD) are used to reduce edema. Yet, the clinical and economic impact of LE treatment has never been evaluated in a representative insured population.
Hypothesis: To investigate whether the use of an advanced PCD (APCD) is associated with improved clinical outcomes and costs in a representative population.
Methods: Health claims were analyzed in a De-identified Normative Health Information database. The database includes >27 million individuals/year comprised of both commercially insured and Medicare Managed Care enrollees from a large USA national managed care health insurer (Optum, Inc). Individuals with a primary or secondary LE diagnosis code prescribed an APCD (Flexitouch®) between 2008-2013 were identified (n=718). Subgroup analysis was performed on a cancer-related LE cohort (n=374). Clinical outcomes included hospitalizations, clinic visits, cellulitis infections, and use of physical therapy. Per patient mean costs were measured in home health, emergency, hospital inpatient & outpatient and office visit settings.
Results: APCD use was associated with a reduction in hospitalizations (28%), outpatient hospital visits (4%), cellulitis episodes (8%), and use of physical therapy (15%). Total costs prior to APCD treatment were $51,495 and APCD use was associated with a 17% total cost decrease 12 months after device use. Non-device related total LE costs were reduced by 36%; outpatient PT costs by 49%, and other outpatient hospital costs by 62%. In the cancer cohort, similar cost reductions were achieved (37% for total LE-related costs; 49% outpatient PT cost; and 55% other outpatient cost reductions).
Conclusions: APCD use for LE achieves the Triple Aim, achieving a striking improvement in individual clinical outcomes, improving population health, and lowering health costs. Cardiovascular specialists who treat patients with both cancer and edema are well positioned to improve the health of individuals affected by LE.
Author Disclosures: A.T. Hirsch: Employment; Significant; Tactile Medical. S. Hoy: Employment; Significant; Tactile Medical. P. Karaca Mandic: Consultant/Advisory Board; Modest; Tactile Medical.
- © 2014 by American Heart Association, Inc.