Comparing Hospital Costs Of Trans-Catheter Aortic Valve Replacement and Isolated Surgical Aortic Valve Replacement in Patients with Aortic Stenosis Treated in New South Wales, Australia

Abstract

Introduction: The data on comparison of costs and benefits for aortic valve replacement from an Australian healthcare perspective are scarce. The study quantifies hospital-associated resource use and costs of trans-catheter valve insertion (TAVI) and surgical aortic valve replacement (SAVR) procedures including length of stay, ICU hours; subsequent hospital admissions related to aortic stenosis, over 12 months. Methods: A retrospective cohort analysis of patients who underwent TAVI or SAVR undertaken at Royal Prince Alfred Hospital (2012–2017). Patients were identified using the hospital patient database and electronic medical records. Resource use was valued using the Independent Hospital Pricing Authority's net efficient price and national weighted activity units (NWAUs). Results are presented as mean values with standard deviations, and costs are presented in 2017 Australian dollars. Results: Of 482 patients, mean age 77 years (SD 13), 64% males:Tabled 1TAVI (SD) n = 186SAVR (SD) n = 296Average length of stay (days)9.24 (10.24)14.26 (13.42)Average hours in ICU23.16 (51.34)78.64 (91.73)Average cost of procedure$68,949 ($24,493)$62,870 ($36,252)Average cost of hospital readmissions (up to 12 months post-procedure)$10,022 ($20,123) [n = 22]$16,030 ($20,658) [n = 55]Total cost$78,971$78,900 Open table in a new tab The costs will be stratified by patients age (< and ≥80 years) and risk scores. Conclusions: 12-month hospital costs for TAVI and SAVR are similar. TAVI costs are largely driven by cost of the prosthesis; SAVR costs are driven by hospital length of stay and ICU hours. A comparative analysis of outcomes for TAVI and SAVR is required to further inform health policy decision-making.