BUDGET IMPACT AND CAPACITY-GENERATION ANALYSIS OF A POST-PROCEDURAL CLINICAL DECISION SUPPORT SYSTEM FOR LENGTH-OF-STAY OPTIMIZATION IN ELECTIVE PERCUTANEOUS CORONARY INTERVENTION ACROSS TWO ASIA-PACIFIC PUBLIC HEALTH SYSTEMS...
Author(s)
Jeff Hsu, MA, MD, Keiichi Kubota, MBA, Arthur Schahin, BS, Tomoyasu Muto, BS, MSc, PhD.
Serv Medical, Singapore, Singapore.
Serv Medical, Singapore, Singapore.
Presentation Documents
OBJECTIVES: Conservative discharge protocols prolong hospitalization after percutaneous coronary intervention (PCI), consuming bed-days that constrain throughput and lengthen elective waiting queues, despite consensus that same-day and 2-3 day discharge is safe for uncomplicated elective PCI. This study estimated the budget impact, bed-day capacity generation, incremental throughput, and gross procedural revenue of a post-procedural clinical decision support system (CDSS) providing algorithmic discharge-readiness scoring versus standard of care for elective PCI and diagnostic angiography across two Asia-Pacific public health systems (Singapore and Thailand), from payer and societal perspectives over a one-year horizon.
METHODS: A two-arm model (CDSS versus standard of care) was applied to elective PCI and angiography; emergent PCI was excluded. A representative public hospital was scaled to national volume. Cost savings counted post-procedural bed-days only; throughput counted total hospitalization days. Post-procedural length of stay was modeled 4-to-2 days (Singapore) and 2-to-1 day (Thailand); angiography 2.25-to-1.0 days. Costs were PPP-adjusted to US dollars (USD$). Thailand inputs used the nationwide Thai PCI Registry; Singapore used institutional volume and Ministry of Health bill data. One-way sensitivity analyses and a break-even threshold were derived.
RESULTS: Per-patient savings were USD$3,333 (Singapore) and USD$640 (Thailand) for elective PCI. Combined national estimates were approximately USD$65 million in annual savings, 72,100 bed-days freed, 5,120 additional elective PCI of capacity, and USD$68 million in gross procedural revenue. Savings and throughput revenue are non-additive. Results were robust across plus-or-minus 20% cost ranges and net-positive at any length-of-stay reduction above zero.
CONCLUSIONS: CDSS-enabled discharge-readiness scoring is projected to deliver substantial savings, freed capacity, and shorter waiting times across two public health systems, warranting prospective validation.
METHODS: A two-arm model (CDSS versus standard of care) was applied to elective PCI and angiography; emergent PCI was excluded. A representative public hospital was scaled to national volume. Cost savings counted post-procedural bed-days only; throughput counted total hospitalization days. Post-procedural length of stay was modeled 4-to-2 days (Singapore) and 2-to-1 day (Thailand); angiography 2.25-to-1.0 days. Costs were PPP-adjusted to US dollars (USD$). Thailand inputs used the nationwide Thai PCI Registry; Singapore used institutional volume and Ministry of Health bill data. One-way sensitivity analyses and a break-even threshold were derived.
RESULTS: Per-patient savings were USD$3,333 (Singapore) and USD$640 (Thailand) for elective PCI. Combined national estimates were approximately USD$65 million in annual savings, 72,100 bed-days freed, 5,120 additional elective PCI of capacity, and USD$68 million in gross procedural revenue. Savings and throughput revenue are non-additive. Results were robust across plus-or-minus 20% cost ranges and net-positive at any length-of-stay reduction above zero.
CONCLUSIONS: CDSS-enabled discharge-readiness scoring is projected to deliver substantial savings, freed capacity, and shorter waiting times across two public health systems, warranting prospective validation.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE40
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)