Evaluating Health Outcomes and Costs Related to In-Hospital Procedures for the Management of Mitral Valve Disease in Spain
Author(s)
Carnero-Alcázar M1, Alvarez-Bartolome M2, Cruz-González I3, Zamorano JL4, Pardo-Sanz A4, Gonzalez P5, Martínez-Pérez Ó6, Cuervo J6
1Hospital Clínico San Carlos, Madrid, B, Spain, 2University Hospital Gregorio Marañón, Madrid, Spain, 3University Hospital of Salamanca, Salamanca, Spain, 4University Hospital Ramon y Cajal, Madrid, Spain, 5Edwards Lifesciences, Madrid, Spain, 6Axentiva Solutions, Barcelona, B, Spain
Presentation Documents
OBJECTIVES: This study evaluates mitral valve disease (MVD) rates of in-hospital intervention (surgical and transcatheter), health outcomes, and related economic burden in Spain using administrative national data.
METHODS: The analysis involves cases registered between 2016-2019 in the Ministry of Health’s public database (RAE-CMBD, using ICD-10 codes). Intervention rates by region and year(x106), patient risk profile (age-adjusted Charlson index), outcomes (death), length of stay (LoS), and DRG-based costs (€2019) were examined. Statistical (Akaike’s criterion) and clinical criteria were used to optimize multivariate logistic and negative binomial regressions to explore factors associated with exitus and LoS, respectively.
RESULTS: A total of 10,533 cases were performed on isolated MVD, which represents a national rate of 228.20 for that period, 19.20% of total structural heart disease (SHD). The MVD death rate (x106) was 15.45, and the in-hospital mortality range was 6.33-7.80%. The unadjusted LoS was 16.5 (18.1) days including 3.5 (8.9) in ICU. Main variables related to death and LoS (p<0.05) were age, gender, non-elective procedure, high-volume centres, and comorbidities (i.e., Acute Myocardial Infarction (AMI), Diabetes with chronic complications (DBTc), and renal disease); and year, age, gender, non-elective procedure, ICU stay, hospital size, and comorbidities (i.e., AMI, Congestive Heart Failure, Peripheral Vascular Disease, Cerebrovascular disease, and DBTc), respectively. Per-patient mean costs increased from 23,489€ (11,848€) in 2016 to 25,037€ (11,025€) in 2019.
Combined MVD and tricuspid were 2,776 cases with a national rate for the entire period of 60.40. The in-hospital mortality range was 6.85-9.98%. Per-patient mean costs also increased from 26,495€ (10,817€) in 2016 to 29,341€ (9,890€) in 2019. The total annual cost for MVD was 63,721,794€ and 19,296,064€ for MVD with tricuspid 18.86% and 5.71% of the total annual cost of SHD, respectively.CONCLUSIONS: The MVD represents a large volume of interventions for SHD with considerable resource utilization and costs in Spain.
Conference/Value in Health Info
Value in Health, Volume 25, Issue 12S (December 2022)
Code
CO7
Topic
Clinical Outcomes, Economic Evaluation, Health Policy & Regulatory, Study Approaches
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Performance-based Outcomes, Public Spending & National Health Expenditures
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)