Affiliation:
1. Division of Cardiac Surgery Department of Cardiac Sciences Libin Cardiovascular Institute Foothills Medical Center University of Calgary Alberta Canada
2. Department of Surgery Kingston General Hospital Queen’s University Kingston Ontario, Canada
3. Institute for Clinical and Evaluative Sciences Queen’s University Kingston Ontario, Canada
4. Department of Public Health Sciences Queen’s University Kingston Ontario Canada
Abstract
Background
Thoracic aortic dissections (
TADs
) and thoracic aortic aneurysms (
TAAs
) are resource intensive. We sought to determine economic burden and healthcare resource use to guide health policy.
Methods and Results
Using universal healthcare coverage data for Ontario, Canada, from 2003 to 2016, a cost‐of‐illness analysis was performed. From a single‐payer's perspective, direct costs (hospitalization, reinterventions, readmissions, rehabilitation, extended care, home care, prescription drugs, and imaging) were assessed in 2017 Canadian dollars. Controls without
TADs
or
TAAs
were matched 10:1 on age, sex, and socioeconomic status to cases with
TADs
or
TAAs
to compare posthospital service use to the general population. Linear and spline regression were used for cost trends. Total hospital costs increased from $9 M to $20.7 M for
TADs
(
P
<0.0001) and $13 M to $18 M for
TAAs
(
P
<0.001). Costs cumulated to $587 M for 17 113 cases. Median hospital costs for
TADs
were $11 525 ($6102 medical, $26 896 endograft, and $30 372 surgery) with an increase over time (
P
=0.04). For
TAAs
, median costs were $16 683 ($7247 medical, $11 679 endograft, and $22 949 surgery) with a decrease over time (
P
=0.03). Home care was the most used posthospital service (
TADs
44%,
TAAs
38%), but rehabilitation had the highest median cost (
TADs
$11.9 M,
TAAs
$11 M). Men had increased median costs for indexed hospitalizations relative to women, yet women used more posthospital services with higher service costs.
Conclusions
Total yearly costs have increased for
TADs
and
TAAs
. Median hospital costs have increased for
TADs
yet decreased for
TAAs
. Women use posthospital healthcare services more often than men.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
27 articles.
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