If hospitals can perform more transradial or same-day PCIs, not only will patients benefit because it is associated with have less complications, but collectively, hospitals across the U.S. could save $300 million each year, according to research published Feb. 20 in JACC: Cardiovascular Interventions.

PCIs cost the U.S. approximately $10 billion each year. Since there have been little data on strategies that can be implemented to help reduce costs of PCI, Amit P. Amin, MD, MSc, et al., evaluated different PCI approaches and care pathways to see which would be least costly. The researchers examined nearly 280,000 Medicare patients in ACC’s CathPCI Registry undergoing PCI who were eligible for same-day discharge. Out of this group, the arm artery access was used in 9 percent of the patients, and same-day discharge was used in 5.3 percent of patients. The adjusted cost associated with arm access with same-day discharge was $13,389 while the cost associated with leg access with overnight stay was $17,076, a difference of $3,689 per PCI procedure.

The authors also found that by shifting practice by 30 percent for more same-day arm access procedures, a hospital performing 1,000 elective PCI procedures per year could reduce costs by approximately $1 million. If collectively all hospitals across the country followed this care pathway, PCI costs would be lowered by almost $300 million annually.

“We now have identified a mechanism for hospitals to improve their efficiency, lower costs and which is associated with improved PCI outcomes simultaneously,” explains Amin. “Our data show there is a tremendous potential to reduce costs of PCI, reduce complications and achieve a ‘win-win’ for both patients and hospitals. Hospitals that redesign their care pathways to perform more same-day, transradial PCIs can potentially save hundreds of thousands of dollars each year.”

He adds the moving forward, “we need to continue to pursue research like this – in all areas of medicine – that demonstrates ways in which higher quality care can be delivered at a lower cost, to elevate the value of health care that our patients deserve.”

Keywords: Arteries, Hospitals, Medicare, Patient Discharge, National Cardiovascular Data Registries, Registries, CathPCI Registry, Angiography

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