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

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  • dc.contributor.author Regueiro, Ander
  • dc.contributor.author Bosch, Julia
  • dc.contributor.author Martín-Yuste, Victoria
  • dc.contributor.author Rosas, Alba
  • dc.contributor.author Faixedas, Maria Teresa
  • dc.contributor.author Gómez-Hospital, Joan Antoni
  • dc.contributor.author Figueras, Jaume
  • dc.contributor.author Curós, Antoni
  • dc.contributor.author Cequier, Angel
  • dc.contributor.author Goicolea, Javier
  • dc.contributor.author Fernández Ortiz, Antonio
  • dc.contributor.author Macaya, Carlos
  • dc.contributor.author Tresserras i Gaju, Ricard, 1957-
  • dc.contributor.author Pellisé Urquiza, Laura
  • dc.contributor.author Sabaté, Manel
  • dc.date.accessioned 2024-12-03T07:36:45Z
  • dc.date.available 2024-12-03T07:36:45Z
  • dc.date.issued 2015
  • dc.description.abstract 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.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Regueiro A, Bosch J, Martín-Yuste V, Rosas A, Faixedas MT, Gómez-Hospital JA, et al. Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network. BMJ Open. 2015 Dec;5(12):e009148. DOI: 10.1136/bmjopen-2015-009148
  • dc.identifier.doi http://dx.doi.org/10.1136/bmjopen-2015-009148
  • dc.identifier.issn 2044-6055
  • dc.identifier.uri http://hdl.handle.net/10230/68901
  • dc.language.iso eng
  • dc.publisher BMJ Publishing Group
  • dc.relation.ispartof BMJ Open. 2015 Dec;5(12):e009148
  • dc.rights This 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/
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • dc.subject.other Infart de miocardi
  • dc.subject.other Fibrinòlisi
  • dc.subject.other Malalties coronàries -- Factors de risc
  • dc.title Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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