Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network

Objectives To evaluate the cost-effectiveness of the ST-segment elevation myocardial infarction (STEMI) network of Catalonia (Codi Infart). Design Cost-utility analysis. Setting The analysis was from the Catalonian Autonomous Community in Spain, with a population of about 7.5 million people. Partici...

Descripción completa

Detalles Bibliográficos
Autores: Regueiro, Ander, Bosch, Julia, Martín-Yuste, Victoria, Rosas, Alba, Faixedas, Maria Teresa, Gómez-Hospital, Joan Antoni, Figueras, Jaume, Curós, Antoni, Cequier, Angel, Goicolea, Javier, Fernández Ortiz, Antonio, Macaya, Carlos, Tresserras i Gaju, Ricard, 1957-, Pellisé Urquiza, Laura, Sabaté, Manel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/68901
Acceso en línea:http://hdl.handle.net/10230/68901
http://dx.doi.org/10.1136/bmjopen-2015-009148
Access Level:acceso abierto
Palabra clave:Infart de miocardi
Fibrinòlisi
Malalties coronàries -- Factors de risc
id ES_5d42330b768d09e5fd092f4ee59c36ef
oai_identifier_str oai:repositori.upf.edu:10230/68901
network_acronym_str ES
network_name_str España
repository_id_str
spelling Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart networkRegueiro, AnderBosch, JuliaMartín-Yuste, VictoriaRosas, AlbaFaixedas, Maria TeresaGómez-Hospital, Joan AntoniFigueras, JaumeCurós, AntoniCequier, AngelGoicolea, JavierFernández Ortiz, AntonioMacaya, CarlosTresserras i Gaju, Ricard, 1957-Pellisé Urquiza, LauraSabaté, ManelInfart de miocardiFibrinòlisiMalalties coronàries -- Factors de riscObjectives To evaluate the cost-effectiveness of the ST-segment elevation myocardial infarction (STEMI) network of Catalonia (Codi Infart). Design Cost-utility analysis. Setting The analysis was from the Catalonian Autonomous Community in Spain, with a population of about 7.5 million people. Participants Patients with STEMI treated within the autonomous community of Catalonia (Spain) included in the IAM CAT II-IV and Codi Infart registries. Outcome measures Costs included hospitalisation, procedures and additional personnel and were obtained according to the reperfusion strategy. Clinical outcomes were defined as 30-day avoided mortality and quality-adjusted life-years (QALYs), before (N=356) and after network implementation (N=2140). Results A substitution effect and a technology effect were observed; aggregate costs increased by 2.6%. The substitution effect resulted from increased use of primary coronary angioplasty, a relatively expensive procedure and a decrease in fibrinolysis. Primary coronary angioplasty increased from 31% to 89% with the network, and fibrinolysis decreased from 37% to 3%. Rescue coronary angioplasty declined from 11% to 4%, and no reperfusion from 21% to 4%. The technological effect was related to improvements in the percutaneous coronary intervention procedure that increased efficiency, reducing the average length of the hospital stay. Mean costs per patient decreased from €8306 to €7874 for patients with primary coronary angioplasty. Clinical outcomes in patients treated with primary coronary angioplasty did not change significantly, although 30-day mortality decreased from 7.5% to 5.6%. The incremental cost-effectiveness ratio resulted in an extra cost of €4355 per life saved (30-day mortality) and €495 per QALY. Below a cost threshold of €30 000, results were sensitive to variations in costs and outcomes. Conclusions The Catalan STEMI network (Codi Infart) is cost-efficient. Further studies are needed in geopolitical different scenarios.BMJ Publishing Group202420242015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/68901http://dx.doi.org/10.1136/bmjopen-2015-009148reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésBMJ Open. 2015 Dec;5(12):e009148This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/689012026-06-12T07:21:37Z
dc.title.none.fl_str_mv Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
title Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
spellingShingle Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
Regueiro, Ander
Infart de miocardi
Fibrinòlisi
Malalties coronàries -- Factors de risc
title_short Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
title_full Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
title_fullStr Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
title_full_unstemmed Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
title_sort Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
dc.creator.none.fl_str_mv Regueiro, Ander
Bosch, Julia
Martín-Yuste, Victoria
Rosas, Alba
Faixedas, Maria Teresa
Gómez-Hospital, Joan Antoni
Figueras, Jaume
Curós, Antoni
Cequier, Angel
Goicolea, Javier
Fernández Ortiz, Antonio
Macaya, Carlos
Tresserras i Gaju, Ricard, 1957-
Pellisé Urquiza, Laura
Sabaté, Manel
author Regueiro, Ander
author_facet Regueiro, Ander
Bosch, Julia
Martín-Yuste, Victoria
Rosas, Alba
Faixedas, Maria Teresa
Gómez-Hospital, Joan Antoni
Figueras, Jaume
Curós, Antoni
Cequier, Angel
Goicolea, Javier
Fernández Ortiz, Antonio
Macaya, Carlos
Tresserras i Gaju, Ricard, 1957-
Pellisé Urquiza, Laura
Sabaté, Manel
author_role author
author2 Bosch, Julia
Martín-Yuste, Victoria
Rosas, Alba
Faixedas, Maria Teresa
Gómez-Hospital, Joan Antoni
Figueras, Jaume
Curós, Antoni
Cequier, Angel
Goicolea, Javier
Fernández Ortiz, Antonio
Macaya, Carlos
Tresserras i Gaju, Ricard, 1957-
Pellisé Urquiza, Laura
Sabaté, Manel
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Infart de miocardi
Fibrinòlisi
Malalties coronàries -- Factors de risc
topic Infart de miocardi
Fibrinòlisi
Malalties coronàries -- Factors de risc
description Objectives To evaluate the cost-effectiveness of the ST-segment elevation myocardial infarction (STEMI) network of Catalonia (Codi Infart). Design Cost-utility analysis. Setting The analysis was from the Catalonian Autonomous Community in Spain, with a population of about 7.5 million people. Participants Patients with STEMI treated within the autonomous community of Catalonia (Spain) included in the IAM CAT II-IV and Codi Infart registries. Outcome measures Costs included hospitalisation, procedures and additional personnel and were obtained according to the reperfusion strategy. Clinical outcomes were defined as 30-day avoided mortality and quality-adjusted life-years (QALYs), before (N=356) and after network implementation (N=2140). Results A substitution effect and a technology effect were observed; aggregate costs increased by 2.6%. The substitution effect resulted from increased use of primary coronary angioplasty, a relatively expensive procedure and a decrease in fibrinolysis. Primary coronary angioplasty increased from 31% to 89% with the network, and fibrinolysis decreased from 37% to 3%. Rescue coronary angioplasty declined from 11% to 4%, and no reperfusion from 21% to 4%. The technological effect was related to improvements in the percutaneous coronary intervention procedure that increased efficiency, reducing the average length of the hospital stay. Mean costs per patient decreased from €8306 to €7874 for patients with primary coronary angioplasty. Clinical outcomes in patients treated with primary coronary angioplasty did not change significantly, although 30-day mortality decreased from 7.5% to 5.6%. The incremental cost-effectiveness ratio resulted in an extra cost of €4355 per life saved (30-day mortality) and €495 per QALY. Below a cost threshold of €30 000, results were sensitive to variations in costs and outcomes. Conclusions The Catalan STEMI network (Codi Infart) is cost-efficient. Further studies are needed in geopolitical different scenarios.
publishDate 2015
dc.date.none.fl_str_mv 2015
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/68901
http://dx.doi.org/10.1136/bmjopen-2015-009148
url http://hdl.handle.net/10230/68901
http://dx.doi.org/10.1136/bmjopen-2015-009148
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMJ Open. 2015 Dec;5(12):e009148
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BMJ Publishing Group
publisher.none.fl_str_mv BMJ Publishing Group
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869409001366618112
score 15,198674

Similares en LA Referencia