Author + information
- Christopher Meduri1,
- Janice Chung2,
- Jenny Gaffney2,
- Simon Henley2,
- Jennifer Williams2 and
- Hemal Gada3
Given TAVR’s broadening application, the budget constraints faced by hospitals, and the higher cost of the TAVR valve compared to SAVR, there is great interest in understanding how hospital costs compare between TAVR and SAVR.
To evaluate in-hospital costs across U.S. hospitals, we conducted a retrospective analysis of patients undergoing TAVR or SAVR between January 1, 2014 – September 30, 2016 using the Premier Hospital Database. Patients were included in the study if they underwent a TAVR or SAVR procedure based on ICD-9 and -10 procedure codes and were 65 years or older at the time of the procedure. Patients were matched 1:1 using propensity score method based on patient age, Charlson comorbidity index grouping (4 indices), gender, race, and payor type. In-hospital costs were defined as the total hospitalization cost including operating room, supply, room and board, ICU, lab, etc. plus pharmacy cost, adjusted to 2016 dollars. We supplemented this aggregate-level cost analysis by examining the average in-hospital costs and reimbursement for TAVR and SAVR at two U.S. hospitals.
We matched 13,030 TAVR and SAVR patients in the Premier Database. The average, unadjusted, total in-patient hospital cost for TAVR was $60,063 (SD=$37,962) compared to $60,319 (SD=$42,144) for SAVR. The total average supply cost was higher for TAVR by $11,407 (TAVR=$26,317, SD: $21,021 versus SAVR=$14,910, SD: $10,860). TAVR had lower average differences of $4,857 for room and board costs (TAVR=$13,286 versus SAVR=$18,143); $2,705 for operating room costs (TAVR=$9,733 versus SAVR=$12,438); and $1,450 for lab costs (TAVR=$2,520 versus SAVR=$3,970).
Average, in-hospital costs between TAVR and SAVR were comparable, with the lower cost of room and board, operating room, and lab offsetting the higher supply cost for TAVR.
STRUCTURAL: Valvular Disease: Aortic