Minimally invasive procedures significantly lower health payer costs and result in fewer missed work-days when compared to open surgery, according to a study published this week in the Journal of the American Medical Association (JAMA) Surgery. Of six procedures examined, the percutaneous coronary intervention (PCI) arm of the study drove the cost savings. This is an important finding, considering that heart disease remains the leading cause of death and disability in the United States and accounts for considerable expenditures in healthcare services, medications and lost productivity.
This analysis of real-world healthcare spending also showed:
- PCI – a minimally invasive procedure to open blocked heart arteries – had the most dramatic cost savings when compared to open heart surgery, saving health payers $30,850 per patient, and 37.7 fewer work-days missed per patient over the course of one year.
- A cost savings of $12,031 and 16.6 fewer absent days from work, per patient, for peripheral revascularization, a non-invasive procedure to restore blood flow to the arteries that supply blood to the body's arms and legs.
- Collectively, the minimally invasive procedures analyzed in the study reduced health plan expenditures by more than $8.9 billion and another $2.2 billion in reduced workplace absenteeism over a one-year period nationally among adults with employer-sponsored health insurance.
"This study addresses the societal value of minimally invasive care," said Cindy Grines , MD, FSCAI, SCAI Trustee, and Vice President of Clinical and Academic Affairs at Detroit Medical Center Cardiovascular Institute. "We know PCI is a safe and effective option for heart disease patients, and when coupled with the data from this study, the case for interventional cardiology and minimally invasive treatment options is resoundingly clear. It saves money, gets our patients back to work quickly and improves their quality of life."
Using data from national health insurance claims and workplace absenteeism data from 2000 to 2009, the study examined the impact of surgery versus less invasive procedures on medical spending and days absent from work for nearly 352,000 patients with employer-sponsored health insurance. The study looked at six types of standard open surgery versus minimally invasive procedures, including data from 14 days before the procedure through 352 days post-procedure to determine a comprehensive understanding of the economic impact.
As the healthcare community wrestles with ways to provide the best possible care to patients while lowering costs, this study helps fill an information gap surrounding the health economics of procedures, including PCI and peripheral revascularization. These new data, paired with PCI's strong clinical outcomes in treatment of cardiovascular disease and its improvement in patient's quality of life, reinforce the case for PCI as an effective treatment option for both patients and payers.
"While costs are an important factor in care delivery, providing the right care and the right treatment at the right time, using clinical guidelines, professional experience and clinical judgment, remains the core tenet in providing treatment recommendations to cardiovascular patients and their families," said SCAI President J. Jeffrey Marshall , MD, FSCAI, Director of the Cardiac Catheterization Laboratory at Northeast Georgia Heart Center in Gainesville, Ga.
In addition to cost savings, the study found PCI and peripheral revascularization significantly increased worker productivity by decreasing the number of days a patient is absent from work, solidifying the role minimally invasive procedures serve along the care continuum in reducing costs to an over-burdened system and bolstering a healthy and productive workforce.
"The study results related to increased worker productivity underscore the findings from our SCAI national survey of heart patients, which found angioplasty and stenting patients got back to work three times faster than heart surgery patients," said Dr. Marshall. "An important priority of interventional cardiology care is restoring quality of life for heart patients by reducing symptoms such as debilitating chest pain and shortness of breath and drastically cutting down post-procedure recovery time to get people back to their full and productive lives."