Hospital costs of revascularization procedures for femoropopliteal arterial disease.

Abstract

On the basis of analyses performed 8 to 10 years ago, hospital costs for percutaneous transluminal angioplasty were believed to be no more than one third those of bypass. Given increasing awareness of cost as an important component in management decisions, updated information is needed. From 1985 to 1991, clinical and hospital cost data were collected prospectively for 255 admissions for femoropopliteal bypass and 82 for femoropopliteal angioplasty. Mean hospital costs and length of stay per admission were calculated for subgroups of patients defined by procedure and indication, and multiple regression analysis was performed. For all admissions the mean hospital cost for angioplasty was $16,341 and for bypass it was $17,076 (nonsignificant difference). Excluding admissions associated with additional procedures, angioplasty cost on average $8019 and bypass $13,439, a significant difference (p = 0.0001). Stratification by indication demonstrated a significant difference for patients with disabling claudication (p = 0.0001), but the difference was of borderline significance for patients with critical ischemia (p = 0.08). An increasing trend in costs for angioplasty of $1270/yr was demonstrated during the study period, whereas the costs for bypass decreased by $370/yr. In contrast to what has been reported previously, the ratios of hospital costs of angioplasty to bypass were 53% for patients with disabling claudication and 75% for those with critical ischemia.