Korean J Thorac Cardiovasc Surg.  2002 May;35(5):365-368.

Financial Impact of Off-Pump Coronary Artery Bypass

• Lim C
• Chang WI
• Kim KB
• Kim Y

Abstract

BACKGROUND: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. MATERIAL AND METHOD: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. RESULT: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups. Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p < 0.01) and ventilator support time(14.9 vs 56.2 hours, p < 0.01) were significantly shorter in the OPCAB group. Total hospital costs were 17,220,000 and 21,250,000(Korean Won) in group I and II , respectively(p < 0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II.
CONCLUSION
OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

Keyword

Financial management; Minimally invasive surgery; Coronary artery bypass

MeSH Terms

Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump*
Fees and Charges
Financial Management
Hospital Charges
Hospital Costs
Humans
Critical Care
Length of Stay
Mortality
Perioperative Care
Prospective Studies
Retrospective Studies
Risk Factors
Surgical Procedures, Minimally Invasive
Ventilators, Mechanical