Author + information
- Baqir A. Lakhani,
- Devender N. Akula,
- Kartik Mehta and
- Alfred Sacchetti
Background: It is standard of care after device implantation to observe patients overnight in the hospital. We report a cost analysis study prior to and after implementing a strategy of same day discharge (SDD) following pacemaker (PM) or defibrillator (ICD) implantation.
Methods: We reviewed the charts of consecutive patients (pts) who underwent pacemaker or ICD implantation electively or emergently between Jan 2010 to May 2015. CRT device implantations, upgrades, and inpatients were excluded from the analysis. In Sept 2012 the SDD strategy for PM and ICD pts was implemented. Universal billing records for each patient were retrieved for the index hospitalization. The associated hospitalization costs for the two groups were compared using Annova statistical test.
Results: Group A included 165 patients (between Jan 2010 to Aug 2012) who were observed overnight. Group B (between Sept 2012 to May 2015) included 195 patients who were implanted following implementation of the SDD strategy. In Group B, 73/195 (37%) patients were not discharged same day due to late case start time, non-device related medical care, pts preference, or device related complications. No significant differences were noted in complication rate between the groups (Group A vs Group B 22% vs 26%, p value 0.47). Mean cost in Group B was significantly lower compared to Group A (143,899 + 7,331 vs 206,929 + 7,922; p value < 0.001).
Conclusions: Our data suggest that same day discharge after pacemaker or defibrillator implantation is cost effective and can be safely implemented in the majority of pts with similar outcomes as patients observed overnight.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: Devices 2
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1149-072
- 2017 American College of Cardiology Foundation