Hospital utilization and costs for spinal cord stimulation compared with enhanced external counterpulsation for refractory angina pectoris

Susanne M. Bondesson, Ulf Jakobsson, Lars Edvinsson, Ingalill Rahm Hallberg

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    4 Citations (Scopus)

    Abstract

    Rationale, aims and objectives  The aim of this study was to compare acute hospital utilization and costs for patients with refractory angina pectoris undergoing spinal cord stimulation (SCS) versus enhanced external counterpulsation (EECP). Method  Seventy-three persons were included in this register study. The acute hospital utilization and costs for SCS and EECP were followed over a period from 12 months before treatment to 24 months after treatment using Patient Administrative Support in Skåne for publicly organized care. Results  SCS was significantly more expensive than EECP (P < 0.001). Both SCS and EECP entailed fewer days of hospitalization for coronary artery disease in the 12-month follow-up compared with the 12 months preceding treatment. Patients treated with EECP showed an association between reduced hospital admissions and an improved Canadian Cardiovascular Society classification class compared with 1 year before treatment. A significant reduction in cost was seen in both the SCS group (P = 0.018 and P = 0.001, respectively) and the EECP group (P = 0.002 and P = 0.045, respectively) during 12 and 24 months of follow-up compared with before treatment. There were no significant differences between the groups for hospitalization days or admissions, including costs, at the different follow-ups. Conclusions  Cost-effective treatment modalities such as SCS and EECP are valuable additions to medical and revascularization therapy in patients with refractory angina pectoris. Pre-existing conditions and the patient's preferences should be taken in consideration when clinicians choose between treatments for this group of patients.

    Original languageEnglish
    Pages (from-to)139-147
    Number of pages8
    JournalJournal of Evaluation in Clinical Practice
    Volume19
    Issue number1
    DOIs
    Publication statusPublished - 2013

    Swedish Standard Keywords

    • Medical and Health Sciences (3)

    Keywords

    • enhanced external counterpulsation
    • hospital utilization
    • refractory angina pectoris
    • spinal cord stimulation

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