微创二尖瓣手术的成本分析：一项加拿大单中心研究

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open Pub Date : 2025-07-01 DOI:10.1016/j.cjco.2025.04.072

Toshiro W.S. Sembo MD, JD , Ali Fatehi Hassanabad MD, MSc , Kailey Stevens MSc , Amy N. Brown MD, MSc, MPH , Ken Parhar MD, MSc , Corey Adams MD, MSc , William D.T. Kent MD, MSc

{"title":"微创二尖瓣手术的成本分析：一项加拿大单中心研究","authors":"Toshiro W.S. Sembo MD, JD , Ali Fatehi Hassanabad MD, MSc , Kailey Stevens MSc , Amy N. Brown MD, MSc, MPH , Ken Parhar MD, MSc , Corey Adams MD, MSc , William D.T. Kent MD, MSc","doi":"10.1016/j.cjco.2025.04.072","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Stakeholders within a publicly funded healthcare system have a duty to consider costs and economics, to utilize finite resources in the most effective manner. We aimed to quantify the postoperative costs associated with mitral valve repair (MVR) at the Foothills Medical Centre in Calgary, Canada.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent MVR from January 2020 to November 2023 was performed. For patients undergoing minimally invasive mitral valve surgery (MIMVS), a postoperative rapid recovery (RR) protocol was introduced. Postoperative costs were analyzed for 3 comparator groups: MIMVS with RR (MIMVS-RR), MIMVS without RR, , and median sternotomy.</div></div><div><h3>Results</h3><div>Care in the cardiovascular intensive care unit (CVICU) is 2.83 times more expensive than care on the cardiac surgery ward. Length of stay (LOS) in the CVICU was identified to be the primary driver of postoperative costs. The CVICU LOS and total LOS for sternotomy patients was longer than those of MIMVS patients. This difference translated to increased postoperative costs for sternotomy compared to MIMVS on a per-patient basis. The postoperative costs associated with sternotomy are 1.42 times higher than those for MIMVS-RR. When modelled with 200 patients, MIMVS-RR represents a postoperative cost-savings of $3.657 million CAD, compared to sternotomy.</div></div><div><h3>Conclusions</h3><div>Following MVR, a minimally invasive approach demonstrates cost-savings, compared to a sternotomy. Reduced CVICU LOS was the primary driver of cost-savings for MIMVS. Further analysis and investigations are required to fully quantify the true economic benefits of MIMVS-RR at our centre.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 871-878"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cost Analysis for Minimally Invasive Mitral Valve Surgery: A Single-Centre Canadian Study\",\"authors\":\"Toshiro W.S. Sembo MD, JD , Ali Fatehi Hassanabad MD, MSc , Kailey Stevens MSc , Amy N. Brown MD, MSc, MPH , Ken Parhar MD, MSc , Corey Adams MD, MSc , William D.T. Kent MD, MSc\",\"doi\":\"10.1016/j.cjco.2025.04.072\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Stakeholders within a publicly funded healthcare system have a duty to consider costs and economics, to utilize finite resources in the most effective manner. We aimed to quantify the postoperative costs associated with mitral valve repair (MVR) at the Foothills Medical Centre in Calgary, Canada.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent MVR from January 2020 to November 2023 was performed. For patients undergoing minimally invasive mitral valve surgery (MIMVS), a postoperative rapid recovery (RR) protocol was introduced. Postoperative costs were analyzed for 3 comparator groups: MIMVS with RR (MIMVS-RR), MIMVS without RR, , and median sternotomy.</div></div><div><h3>Results</h3><div>Care in the cardiovascular intensive care unit (CVICU) is 2.83 times more expensive than care on the cardiac surgery ward. Length of stay (LOS) in the CVICU was identified to be the primary driver of postoperative costs. The CVICU LOS and total LOS for sternotomy patients was longer than those of MIMVS patients. This difference translated to increased postoperative costs for sternotomy compared to MIMVS on a per-patient basis. The postoperative costs associated with sternotomy are 1.42 times higher than those for MIMVS-RR. When modelled with 200 patients, MIMVS-RR represents a postoperative cost-savings of $3.657 million CAD, compared to sternotomy.</div></div><div><h3>Conclusions</h3><div>Following MVR, a minimally invasive approach demonstrates cost-savings, compared to a sternotomy. Reduced CVICU LOS was the primary driver of cost-savings for MIMVS. Further analysis and investigations are required to fully quantify the true economic benefits of MIMVS-RR at our centre.</div></div>\",\"PeriodicalId\":36924,\"journal\":{\"name\":\"CJC Open\",\"volume\":\"7 7\",\"pages\":\"Pages 871-878\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CJC Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589790X25003105\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CJC Open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589790X25003105","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景公共资助的医疗保健系统中的利益相关者有责任考虑成本和经济性，以最有效的方式利用有限的资源。我们的目的是量化加拿大卡尔加里Foothills医疗中心二尖瓣修复（MVR）的术后费用。方法对2020年1月至2023年11月接受MVR手术的患者进行回顾性分析。对于接受微创二尖瓣手术（MIMVS）的患者，引入了术后快速恢复（RR）方案。分析了3个比较组的术后费用：有RR的MIMVS （MIMVS-RR）、无RR的MIMVS和正中胸骨切开术。结果心血管重症监护病房（CVICU）的费用是心脏外科病房的2.83倍。在CVICU的住院时间（LOS）被确定为术后费用的主要驱动因素。胸骨切开术患者的CVICU LOS和总LOS均长于MIMVS患者。这种差异转化为胸骨切开术与MIMVS相比，每个患者的术后成本增加。胸骨切开术的术后费用是MIMVS-RR的1.42倍。当对200名患者进行建模时，与胸骨切开术相比，MIMVS-RR代表术后成本节省365.7万加元。结论：与胸骨切开术相比，MVR术后采用微创入路可节省成本。减少CVICU LOS是节省MIMVS成本的主要驱动因素。需要进一步的分析和调查，以充分量化我们中心的MIMVS-RR的真正经济效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Cost Analysis for Minimally Invasive Mitral Valve Surgery: A Single-Centre Canadian Study

Background

Stakeholders within a publicly funded healthcare system have a duty to consider costs and economics, to utilize finite resources in the most effective manner. We aimed to quantify the postoperative costs associated with mitral valve repair (MVR) at the Foothills Medical Centre in Calgary, Canada.

Methods

A retrospective review of patients who underwent MVR from January 2020 to November 2023 was performed. For patients undergoing minimally invasive mitral valve surgery (MIMVS), a postoperative rapid recovery (RR) protocol was introduced. Postoperative costs were analyzed for 3 comparator groups: MIMVS with RR (MIMVS-RR), MIMVS without RR, , and median sternotomy.

Results

Care in the cardiovascular intensive care unit (CVICU) is 2.83 times more expensive than care on the cardiac surgery ward. Length of stay (LOS) in the CVICU was identified to be the primary driver of postoperative costs. The CVICU LOS and total LOS for sternotomy patients was longer than those of MIMVS patients. This difference translated to increased postoperative costs for sternotomy compared to MIMVS on a per-patient basis. The postoperative costs associated with sternotomy are 1.42 times higher than those for MIMVS-RR. When modelled with 200 patients, MIMVS-RR represents a postoperative cost-savings of $3.657 million CAD, compared to sternotomy.

Conclusions

Following MVR, a minimally invasive approach demonstrates cost-savings, compared to a sternotomy. Reduced CVICU LOS was the primary driver of cost-savings for MIMVS. Further analysis and investigations are required to fully quantify the true economic benefits of MIMVS-RR at our centre.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊