A Look at Medicare Patients with Heart Pumps
Posted on: Wednesday, 3 December 2008, 09:38 CST
A new study looking at Medicare patients who receive assistive heart pumps found high rates of death, illness and prolonged hospital stays, resulting in high costs of care.
In 2003 Medicare expanded it’s coverage of a type of heart pump called a ventricular assist device. Ventricular assist devices consist of a mechanical pump that takes over the function of a damaged ventricle of the heart and helps restore normal blood flow. These devices are used in patients with end-stage heart failure who are awaiting heart transplantation, as permanent therapy for patients who are not candidates for transplantation and as a rescue therapy for patients who are in shock after open-heart surgery.
Since little is known about the long-term outcomes and costs associated with ventricular assist devices, a group of Duke University School of Medicine researchers analyzed the trends in use, outcomes and costs for Medicare fee-for-service beneficiaries. The study included patients who received a ventricular assist device as primary therapy or after heart surgery (postcardiotomy).
Researchers found the overall one-year survival was 51.5 percent in the primary device group and 30.8 percent in the postcardiotomy group. Of the patients in the primary device who were discharged from the hospital alive with the device, 55.6 percent were readmitted within six months. Of the patients in the postcardiotomy group who were discharged alive 48.3 percent were readmitted within six months.
One-year Medicare payments for inpatient care of primary device patients totaled approximately $228 million, and were about $151 million for inpatient care of postcardiotomy patients.
SOURCE: The Journal of the American Medical Association, 2008:300;2398-2406
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Source: Ivanhoe
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