Cost Effectiveness Analysis and Payment Policy Recommendation—Population-Based Survey with Big Data Methodology for Readmission Prevention of Patients with Paroxysmal Supraventricular Tachycardia treated with Radiofrequency Catheter Ablation
Abstract
:1. Introduction
- What are the incidence rates of “PSVT-related admission” in patients treated with or without RFCA at first admission?
- What is the difference in the risk of PSVT recurrence between patient groups treated with and without RFCA?
- From the perspective of cost-effectiveness, can RFCA really prevent recurrence of PSVT? Can recurrence of the disease be delayed?
- In a first admission for PSVT, what is the incremental cost of hospitalization required in order to increase recurrence-free life by one year?
- Is there any difference in survival between the two groups (RFCA versus non-RFCA)?
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | PSVT (N = 21,086) | % | Average ± SD | Min | Max |
---|---|---|---|---|---|
Gender | |||||
Male | 9393 | 44.55% | |||
Female | 11,693 | 55.45% | |||
Age (years) | 53.2 ± 17.7 | 20 | 102 | ||
≤44 | 6950 | 32.96% | |||
45–59 | 6498 | 30.82% | |||
60–74 | 4660 | 22.10% | |||
75–89 | 2774 | 13.16% | |||
≥90 | 204 | 0.97% | |||
Hospitalization duration (days) | 3.3 ± 6.6 | 0 | 753 | ||
0–3 | 16,336 | 77.47% | |||
4–7 | 3538 | 16.78% | |||
8–14 | 890 | 4.22% | |||
15–21 | 184 | 0.87% | |||
22–29 | 66 | 0.31% | |||
>30 | 72 | 0.34% | |||
Season | |||||
Spring | 5591 | 26.52% | |||
Summer | 5264 | 24.96% | |||
Autumn | 5149 | 24.42% | |||
Winter | 5082 | 24.10% |
Year | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
PSVT first admission | 24.83 | 24.65 | 21.91 | 22.9 | 21.77 | 21.37 | 21.85 | 20.97 | 21.38 | 21.37 | 20.88 | 20.99 |
AAPC 1 | −1.7 (95% CI 2: −3.0~−0.3) |
Year | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | AAPC 1 (95% CI 2) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age stratum (years) | |||||||||||||
20–45 | 6.475 | 7.175 | 5.846 | 6.952 | 6.158 | 6.018 | 6.235 | 5.545 | 6.273 | 6.257 | 6.682 | 6.260 | −0.5 (−1.8~0.9) |
46–64 | 17.434 | 15.734 | 11.987 | 13.375 | 12.212 | 11.399 | 13.070 | 12.142 | 12.271 | 11.954 | 11.134 | 11.963 | −3.8 (−6.5~−1.0) |
≥65 | 30.092 | 29.616 | 23.015 | 23.359 | 21.295 | 21.093 | 20.388 | 19.177 | 19.424 | 20.584 | 17.862 | 18.563 | −4.4 (−6.5~−2.5) |
Gender stratum | |||||||||||||
Male | 11.343 | 10.757 | 8.725 | 9.560 | 9.065 | 8.136 | 8.901 | 8.670 | 8.933 | 8.720 | 8.665 | 8.428 | −2.8 (−5.0~−0.5) |
Female | 13.069 | 13.730 | 10.638 | 12.124 | 10.644 | 11.054 | 11.494 | 10.208 | 11.033 | 11.460 | 10.764 | 11.414 | −1.3 (−2.7~0.1) |
PSVT First Admission N = 21,086 | Group 1 | Group 2 | Relative Risk RR (95% CI) |
---|---|---|---|
With RFCA N = 13,075 (100%) | Without RFCA N = 8011 (100%) | ||
PSVT readmission | 374 (2.86) | 1751 (21.86) | 0.13 (0.12–0.15) |
PSVT no readmission | 12,701 (97.14) | 6260 (78.14) |
Group 1 (N = 13,075) | Group 2 (N = 8011) | Odds Ratio (95% CI) | |
---|---|---|---|
PSVT Readmissions 374 (100%) | PSVT Readmissions 1751 (100%) | ||
Performed RFCA | 280 (74.87) | 1015 (57.97) | 2.16 (1.68–2.78) |
Did not perform RFCA | 94 (25.13) | 736 (42.03) |
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Chan, C.-L.; Li, A.-H.A.; Chung, H.-A.; Phan, D.-V. Cost Effectiveness Analysis and Payment Policy Recommendation—Population-Based Survey with Big Data Methodology for Readmission Prevention of Patients with Paroxysmal Supraventricular Tachycardia treated with Radiofrequency Catheter Ablation. Int. J. Environ. Res. Public Health 2020, 17, 2334. https://doi.org/10.3390/ijerph17072334
Chan C-L, Li A-HA, Chung H-A, Phan D-V. Cost Effectiveness Analysis and Payment Policy Recommendation—Population-Based Survey with Big Data Methodology for Readmission Prevention of Patients with Paroxysmal Supraventricular Tachycardia treated with Radiofrequency Catheter Ablation. International Journal of Environmental Research and Public Health. 2020; 17(7):2334. https://doi.org/10.3390/ijerph17072334
Chicago/Turabian StyleChan, Chien-Lung, Ai-Hsien Adams Li, Hsiang-An Chung, and Dinh-Van Phan. 2020. "Cost Effectiveness Analysis and Payment Policy Recommendation—Population-Based Survey with Big Data Methodology for Readmission Prevention of Patients with Paroxysmal Supraventricular Tachycardia treated with Radiofrequency Catheter Ablation" International Journal of Environmental Research and Public Health 17, no. 7: 2334. https://doi.org/10.3390/ijerph17072334