Comparative analysis of cardiac surgical outcomes across different healthcare funding modalities: a comprehensive cohort study.

IF 0.6 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-10-01 Epub Date: 2025-06-30 DOI:10.1007/s12055-025-01987-8

Sufina Shales, Paramita Auddya Ghorai, Bharath Sundar, Anit Kumar, Kunal Patel, Sukanta Kumar Behera, Atanu Saha, Pradeep Narayan

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引用次数: 0

Abstract

Aim: To critically examine patient outcomes across different funding categories in cardiac surgical interventions.

Methods: A retrospective cohort analysis was conducted on patients undergoing cardiac surgery between April 2017 and August 2023 at a single institution. Patients were stratified into six distinct funding categories: Cash Payment, Insurance, Government Schemes, Fund/Trust, Public Sector Unit, and the state-specific Swasthya Sathi patients. We examined three major surgical procedures: isolated coronary artery bypass grafting (CABG), aortic valve replacement, and mitral valve replacement. The primary outcome was mortality rates across various funding schemes and specific surgical procedures.

Results: The overall mortality rate was 2.40%, with no statistically significant differences observed across funding categories (p = 0.74). Mortality rates for individual procedures were also comparable across funding sources: aortic valve replacement (p = 0.70), mitral valve replacement (p = 0.11), and isolated CABG (p = 0.68). Specifically, when comparing government scheme patients to cash-paying patients, no significant differences were found for aortic valve replacement (p = 0.65), mitral valve replacement (p = 0.53), or isolated CABG (p = 0.45). Among patients covered under West Bengal's state-sponsored Swasthya Sathi scheme, the mortality rate was 2.2%, compared to 2.7% in non-Swasthya Sathi patients (p = 0.47).

Conclusion: Our study provides preliminary evidence that challenges the widespread perception of inferior care for government-funded patients. The study suggests that the funding mechanism does not significantly impact surgical outcomes in this cardiac surgery cohort, highlighting the potential effectiveness of diverse healthcare financing models in delivering equitable medical care.

Graphical abstract:

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-025-01987-8.

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不同医疗资助方式对心脏手术结果的比较分析：一项综合队列研究。

目的：严格检查不同资助类别的心脏外科干预患者的结果。方法：回顾性队列分析2017年4月至2023年8月在同一医院接受心脏手术的患者。患者被分为六个不同的资助类别：现金支付、保险、政府计划、基金/信托、公共部门单位和国家特定的Swasthya Sathi患者。我们研究了三种主要的外科手术：孤立冠状动脉旁路移植术（CABG）、主动脉瓣置换术和二尖瓣置换术。主要结果是各种供资计划和特定外科手术的死亡率。结果：总死亡率为2.40%，不同资助类别间差异无统计学意义（p = 0.74）。不同资金来源的单个手术的死亡率也具有可比性：主动脉瓣置换术（p = 0.70）、二尖瓣置换术（p = 0.11）和孤立性CABG （p = 0.68）。具体来说，当比较政府方案患者与现金支付患者时，主动脉瓣置换术（p = 0.65）、二尖瓣置换术（p = 0.53）或孤立性CABG （p = 0.45）没有发现显著差异。在西孟加拉邦政府资助的Swasthya Sathi计划涵盖的患者中，死亡率为2.2%，而非Swasthya Sathi患者的死亡率为2.7% （p = 0.47）。结论：我们的研究提供了初步的证据，挑战了对政府资助患者的劣质护理的普遍看法。该研究表明，在心脏手术队列中，资金机制对手术结果没有显著影响，强调了不同医疗融资模式在提供公平医疗服务方面的潜在有效性。图片摘要：补充信息：在线版本包含补充资料，可在10.1007/s12055-025-01987-8获得。

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来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.