Comparison Of Annual Cost And Resource Utilization For Heart Failure Patients In South Korea: Between 2009 And 2011

Abstract

Objectives: Few studies have attempted to quantify the costs of operating room (OR) time. The purpose of this study is to quantify the variable cost per OR minute in isolated non-robotic valvular procedures -aortic valve replacement (AVR), mitral valve replacement (MVR), and mitral valve repair (MVRepair). MethOds:The Premier database, one of the most comprehensive hospital databases, was queried from 2007 to 2011 for patients undergoing AVR, MVR, or MVRepair. This database contains complete billing, hospital cost, and coding data from > 600 US facilities. Patients were identified using the following International Classification of Diseases 9 th Revision (ICD-9) procedure codes: AVR 35. 21, 35.22; MVR 35.23, 35.24; and MVRepair 35.12. Patients having coronary artery bypass grafting were excluded. The surgical approaches, right thoracotomy (RT) and any sternal incision, were identified for each patient with expert clinical assistance. Patients with right thoracotomy were then propensity score matched to patients with any sternal incision, adjusting for patient differences. Premier classified variable costs of the OR into three categories; staff for the surgery room, anesthesia, and recovery room. Outliers were identified based on the cost per minute of the procedure. The top and bottom five percent were removed. All costs were adjusted to 2012 dollars using the Medical Care Component of the Consumer Price Index. Results: There were 2,657 valvular procedures -1,604 AVR, 434 MVR, and 619 MVRepair -that met the inclusion criteria. The average cost per OR minute