Publish in this journal
Journal Information
Share
Share
Download PDF
More article options
ePub
Visits
...
Original article
Available online 22 March 2024
Characterizing the “iceberg peak” in valvular heart disease: Outcomes and costs of in-hospital procedures in Spain
El «pico del iceberg» en la enfermedad valvular: resultados y costes de procedimientos hospitalarios en España
Visits
32
Mercedes Álvarez-Bartoloméa,
Corresponding author
mmalvarezb@telefonica.net

Corresponding author.
, Ignacio Cruz-Gonzálezb,c,d, Ana Pardo-Sanzc,e, José Luis Zamoranoc,e, Paloma Gonzálezf, Óscar Martínez-Pérezg, Jesús Cuervog, Manuel Carnero-Alcázarh
a Dirección Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Sección de Hemodinámica e Intervencionismo Estructural, Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain
c Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Spain
d Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
e Departamento de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
f Edwards Lifesciences, Madrid, Spain
g Axentiva Solutions, Barcelona, Spain
h Servicio de Cirugía Cardiaca de Adultos, Hospital Clínico San Carlos, Madrid, Spain
This item has received
Received 29 January 2024. Accepted 23 February 2024
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (4)
Table 1. Descriptive summary of annual valvular heart disease procedures.
Table 2. Annual valvular heart disease procedures complications summary.
Table 3. Annual valvular heart disease in-hospital mortality, length of stay, and costs summary.
Table 4. Length of stay summary according to health outcome in valvular heart disease procedures.
Show moreShow less
Additional material (1)
Abstract
Introduction and objectives

The aim was to describe the burden of disease of valvular heart disease (VHD) in-hospital interventions in Spain.

Methods

The analysis involved all cases between 2016 and 2019 in the Spanish Ministry of Health database under the International Classification of Diseases 10th Revision. Procedure rates by region and year (×106), patient risk profile (comorbidities), health outcomes (death), length of stay (LoS), and costs were examined.

Results

A total of 57878 procedures were analyzed, representing a national rate from 292 in 2016 to 321 in 2019 (×106 inhabitants). Comorbidities measured by the age-adjusted Charlson Comorbidity Index ranged between 3.47 and 3.77 and increased over the period. The in-hospital complications have remained constant over the years with some exceptions. Death rate (×106 inhabitants) was 18.0, and the in-hospital mortality per year range was statistically constant and between 5.23% and 6.20%. The unadjusted LoS ranged from 14.68 to 15.34 days (standard deviations [SD], 16.03 and 15.79) including 2.68 to 3.27 days (SD, 6.57–7.82) in the intensive care unit. VHD procedures costs amounted to €1403.13 million in the period, representing an annual cost of €350.8 million. These costs decreased by 3.17% over the period. Per-procedure mean cost also decreased from €24801.81 (SD, €10231.91) to €24015.50 (SD, €9825.39).

Conclusions

VHD entails a large and increasing volume of procedures in Spain. While a decline in the per-procedure mean cost was noted, the overall annual cost increased. This underscores the substantial burden on the national health system, even when considering solely in-hospital procedures.

Keywords:
Valvular heart diseases
Health care cost
Hospitalization
Spain
Burden of disease
Abbreviations:
a-CCIage
DRG
LoS
VHD
Resumen
Introducción y objetivos

El propósito fue describir la carga de las intervenciones hospitalarias en la enfermedad valvular cardiaca (EVC) en España.

Métodos

El análisis incluyó los registros de la base de datos bajo la Clasificación Internacional de Enfermedades, 10.ª Revisión del Ministerio de Sanidad de España entre 2016-2019. Se examinaron tasas de procedimientos por región y año, perfil de riesgo (comorbilidades), resultados (defunciones), duración de la estancia y costes.

Resultados

Se analizaron 57.878 procedimientos, representando una tasa nacional de 292 en 2016 a 321 en 2019 (×106 habitantes). El índice de comorbilidad de Charlson ajustado por edad estuvo entre 3,47-3,77 y aumentó durante el periodo descrito. Las complicaciones hospitalarias fueron constantes durante los años, con excepciones. La tasa de mortalidad (×106 hab.) fue de 18,0 y la mortalidad hospitalaria por año se mantuvo estadísticamente constante entre 5,23-6,20%. La estancia hospitalaria sin ajustar fue de 14,68-15,34 días (desviación estándar [DE]: 16,03-15,79), incluyendo 2,68-3,27 días (DE: 6,57-7,82) en la unidad de cuidados intensivos. El coste fue 1.403,13 millones de euros en el periodo, lo que representa un coste anual de 350,8 millones de euros. Estos disminuyeron un 3,17% durante el periodo. El coste medio por procedimiento disminuyó de 24.801,81 euros (DE: 10.231,91 euros) a 24.015,50 euros (DE: 9.825,39 euros).

Conclusiones

La EVC implica un volumen importante y creciente de procedimientos en España. Aunque el coste por procedimiento parece que disminuyó, el coste anual total ha aumentado. Esto representa una carga sustancial al sistema de salud nacional, incluso considerando únicamente intervenciones hospitalarias.

Palabras clave:
Enfermedades de las válvulas cardiacas
Costes sanitarios
Hospitalización
España
Carga de enfermedad

Article

These are the options to access the full texts of the publication REC: CardioClinics
Member
Socios SEC
Use datos de acceso a SEC en el menú Acceder.
Si es socio de la Sociedad Española de Cardiología y no puede acceder con sus claves, escriba a rec@cardioclinics.org.
Members of SEC
Use the Society's website login and password here.
If you are member of SEC and you have some problems with your login data, please contact with rec@cardioclinics.org.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

REC: CardioClinics

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
REC: CardioClinics
Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?