Factors Associated With Unplanned Hospital Readmissions and Emergency Presentation Following Percutaneous Coronary Intervention: Insights From the Victorian Cardiac Outcomes Registry

Biswas, Sinjini; Tacey, Mark; Dinh, D.; Brennan, A.; Andrianopoulos, Nick; Zomer, Ella; Haikerwal, Deepak; Toogood, G.; Oqueli, Ernesto; Nadarajah, N.; Warren, R.; Gooley, Robert; Horrigan, M.; Reid, C.; Lefkovits, Jeffrey

doi:10.1016/j.hlc.2018.06.920

Cited by 2 publications

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“…12 VAED variables reflect hospital activity for funding purposes. 13 14 Of 32 852 patients enrolled in VCOR between 1 January 2013 and 31 December 2017 who were alive at 30 days following PCI, 194 were excluded from linkage due to insufficient case information, and successful matching was achieved for 28 488 (87%) patients. 15 For the purposes of this study, we analysed data for all PCIs undertaken in Victorian public hospitals from 1 January 2014 to 31 December 2017.…”

Section: Methodsmentioning

confidence: 99%

Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study

et al. 2021

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ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the Australian healthcare system perspective.SettingA linked dataset of patients admitted to public hospitals for PCI in Victoria was drawn from the Victorian Cardiac Outcomes Registry (VCOR) and the Victorian Admitted Episodes Dataset. Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.

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Section: Methodsmentioning

confidence: 99%

Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study

et al. 2021

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“… 12 , 13 The VAED contains admissions, diagnostic and procedural data across all Victorian hospitals; variables in the VAED reflect hospital activity for funding purposes. 12 , 13 Linkage with the National Death Index (NDI) was also performed to allow the estimation of long‐term mortality for patients undergoing PCI. 10 , 12 For the purposes of the present study, data on all consecutive PCI procedures in VCOR conducted over a 4‐year period between January 1, 2014, and December 31, 2017, were considered.…”

Section: Methodsmentioning

confidence: 99%

“… 12 , 13 Linkage with the National Death Index (NDI) was also performed to allow the estimation of long‐term mortality for patients undergoing PCI. 10 , 12 For the purposes of the present study, data on all consecutive PCI procedures in VCOR conducted over a 4‐year period between January 1, 2014, and December 31, 2017, were considered. The population was stratified by sex and indication for PCI (non‐ACS, unstable angina [UA], non‐ST‐elevation myocardial infarction [NSTEMI], and ST‐elevation myocardial infarction [STEMI]).…”

Section: Methodsmentioning

confidence: 99%

“…The primary VCOR data set was linked to the Victorian Admitted Episodes Data set (VAED) to estimate the costs of PCIs 12,13 . The VAED contains admissions, diagnostic and procedural data across all Victorian hospitals; variables in the VAED reflect hospital activity for funding purposes 12,13 . Linkage with the National Death Index (NDI) was also performed to allow the estimation of long‐term mortality for patients undergoing PCI 10,12 .…”

Section: Methodsmentioning

confidence: 99%

“…12,13 Linkage with the National Death Index (NDI) was also performed to allow the estimation of long-term mortality for patients undergoing PCI. 10,12 For the purposes of the present study, data on all consecutive PCI procedures in VCOR conducted over a…”

Section: Data Sourcementioning

confidence: 99%

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The cost‐effectiveness of radial access percutaneous coronary intervention: A propensity‐score matched analysis of Victorian data

Lee

Brennan

Dinh

et al. 2022

Clinical Cardiology

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Background: Despite evidence of the comparative benefits of transradial access percutaneous coronary intervention (PCI) over transfemoral access, its uptake remains highly varied across Australia. Few studies have explored the implications of the choice of access site during PCI from the perspective of the Australian healthcare setting. We, therefore, performed a cost-effectiveness analysis of radial versus femoral access PCI.Methods: Data from the Victorian Cardiac Outcomes Registry (VCOR) were used to inform our economic analyses. Patients treated through either radial or femoral access PCI were propensity score-matched using the inverse probability weighted (IPW) method, and the incidence of major bleeding and all-cause mortality in the cohort was used to inform an economic model comprising a hypothetical sample of 1000 patients. Costs and utility data were drawn from published sources. The economic evaluation adopted the perspective of the Australian healthcare system.Results: Among a cohort of 1000 patients over 1 year, there were 19 fewer deaths, and six fewer episodes of nonfatal major bleeding in the radial group compared to the femoral group. Total cost savings attributed to radial access was AUD $1 214 688. Hence, from a health economic point of view, radial access PCI was dominant over femoral access PCI. Sensitivity analyses supported the robustness of these findings.Conclusions: Radial access is associated with improved patient outcomes and considerably lower costs relative to femoral access PCI. Our findings support radial access being the preferred approach for PCI across a variety of indications in

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Factors Associated With Unplanned Hospital Readmissions and Emergency Presentation Following Percutaneous Coronary Intervention: Insights From the Victorian Cardiac Outcomes Registry

Cited by 2 publications

References 0 publications

Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study

Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study

The cost‐effectiveness of radial access percutaneous coronary intervention: A propensity‐score matched analysis of Victorian data

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