The Impact of Cryoballoon Versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation on Healthcare Utilization and Costs: An Economic Analysis From the FIRE AND ICE Trial.
The Impact of Cryoballoon Versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation on Healthcare Utilization and Costs: An Economic Analysis From the FIRE AND ICE Trial.
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DOI：
10.1161/jaha.117.006043
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发表时间：
2017-07-27
影响因子：
5.4
通讯作者：
FIRE AND ICE Investigators
中科院分区：
文献类型：
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作者：
Chun KRJ;Brugada J;Elvan A;Gellér L;Busch M;Barrera A;Schilling RJ;Reynolds MR;Hokanson RB;Holbrook R;Brown B;Schlüter M;Kuck KH;FIRE AND ICE Investigators
本研究旨在评估随机FIRE AND ICE试验中阵发性房颤冷冻球囊或射频电流（RFC）导管消融术后的支付方成本。医疗保健成本的试验期分析评价了消融方式（冷冻球囊与RFC）对资源使用差异和相关支付者成本的影响。分析基于试验期间的重复干预、再住院和心脏复律，单位成本基于3个国家医疗保健系统（德国[€]、英国[£]和美国[]）。通过将标准单位成本应用于住院时间，使用国际疾病分类第10次修订版诊断和映射到国家特定诊断相关组的程序代码计算总支付者成本。患者（N=750）按1：1随机分配至冷冻球囊（n=374）或RFC（n=376）消融，平均随访1.5年。冷冻球囊组的资源使用低于RFC组（122例患者发生205起住院和/或干预事件，154例患者发生268起事件）。随访期间，每例患者的平均总支付者成本差异分别为640欧元、364英镑和925英镑，支持冷冻球囊消融术（分别为P=0.012、0.013和0.016）。这导致试验期总成本节省245，000欧元，140，000英镑和355，000英镑。与RFC消融相比，冷冻球囊消融与资源使用和支付者成本的减少相关。在分析的所有3个国家医疗保健系统中，这一减少导致了大量的试验期成本节省，主要归因于重复消融减少和冷冻球囊消融心血管再住院减少。网址：http://www.clinicaltrials.gov。标识符：NCT 01490814。
This study sought to assess payer costs following cryoballoon or radiofrequency current (RFC) catheter ablation of paroxysmal atrial fibrillation in the randomized FIRE AND ICE trial. A trial period analysis of healthcare costs evaluated the impact of ablation modality (cryoballoon versus RFC) on differences in resource use and associated payer costs. Analyses were based on repeat interventions, rehospitalizations, and cardioversions during the trial, with unit costs based on 3 national healthcare systems (Germany [€], the United Kingdom [£], and the United States []). Total payer costs were calculated by applying standard unit costs to hospital stays, using International Classification of Diseases, 10th Revision diagnoses and procedure codes that were mapped to country‐specific diagnosis‐related groups. Patients (N=750) randomized 1:1 to cryoballoon (n=374) or RFC (n=376) ablation were followed for a mean of 1.5 years. Resource use was lower in the cryoballoon than the RFC group (205 hospitalizations and/or interventions in 122 patients versus 268 events in 154 patients). The cost differences per patient in mean total payer costs during follow‐up were €640, £364, and 925 in favor of cryoballoon ablation (P=0.012, 0.013, and 0.016, respectively). This resulted in trial period total cost savings of €245 000, £140 000, and 355 000. When compared with RFC ablation, cryoballoon ablation was associated with a reduction in resource use and payer costs. In all 3 national healthcare systems analyzed, this reduction resulted in substantial trial period cost savings, primarily attributable to fewer repeat ablations and a reduction in cardiovascular rehospitalizations with cryoballoon ablation. URL: http://www.clinicaltrials.gov. Identifier: NCT01490814.