Cost analysis of treating cardiovascular diseases in a super-specialty hospital.

Atul Kumar,Rajiv Narang,Vijaydeep Siddharth,Soubam Iboyaima Singh,Filomena Pietrantonio

doi:10.1371/journal.pone.0262190

Abstract

Cardiovascular care is expensive; hence, economic evaluation is required to estimate resources being consumed and to ensure their optimal utilization. There is dearth of data regarding cost analysis of treating various diseases including cardiac diseases from developing countries. The study aimed to analyze resource consumption in treating cardio-vascular disease patients in a super-specialty hospital. An observational and descriptive study was carried out from April 2017 to June 2018 in the Department of Cardiology, Cardio-Thoracic (CT) Centre of All India Institute of Medical Sciences, New Delhi, India. As per World Health Organization, common cardiovascular diseases i.e. Coronary Artery Disease (CAD), Rheumatic Heart Disease (RHD), Cardiomyopathy, Congenital heart diseases, Cardiac Arrhythmias etc. were considered for cost analysis. Medical records of 100 admitted patients (Ward & Cardiac Care Unit) of cardiovascular diseases were studied till discharge and number of patient records for a particular CVD was identified using prevalence-based ratio of admitted CVD patient data. Traditional Costing and Time Driven Activity Based Costing (TDABC) methods were used for cost computation. Per bed per day cost incurred by the hospital for admitted patients in Cardiac Care Unit, adult and pediatric cardiology ward was calculated to be Indian Rupee (INR) 28,144 (US$ 434), INR 22,210 (US$ 342) and INR 18,774 (US$ 289), respectively. Inpatient cost constituted almost 70% of the total cost and equipment cost accounted for more than 50% of the inpatient cost followed by human resource cost (28%). Per patient cost of treating any CVD was computed to be INR 2,47,822 (US $ 3842). Cost of treating Rheumatic Heart Disease was the highest among all CVDs followed by Cardiomyopathy and other CVDs. Cost of treating cardiovascular diseases in India is less than what has been reported in developed countries. Findings of this study would aid policy makers considering recent radical changes and massive policy reforms ushered in by the Government of India in healthcare delivery.

Highlights

Most common cardiovascular diseases (CVDs) was Coronary Artery Disease (CAD), which constituted more than 50 percent of the admitted patients
A study done in India found that prevalence of CVDs increased in all states of India, and coronary artery diseases tops the list among CVDs followed by stroke, while rheumatic heart
Cost of treating CVDs in developed countries appears to be much higher compared to what has been observed in this study

Summary

Methods

All India Institute of Medical Sciences is one of the leading healthcare institute in the country and CTC began functioning in 1982 with 200 hospital beds for Cardiology and Cardiothoracic & Vascular Surgery patients It has all the facilities required for comprehensive cardiac care including a catherization laboratory, cardiac anesthesia, cardiac radiology, cardiac biochemistry, cardiac pathology, nuclear medicine, stem cell facility, organ retrieval & banking organization, blood transfusion services etc. Study did not involve any direct or indirect interaction with patients and ethical guidelines as prescribed by the Institute Ethics Committee for the patient record review were adhered It entailed identifying various cost centres, classifying costs and tracing all costs related to treating cardiovascular diseases through detailed and thorough perusal of various records including inpatient records to ascertain resource consumption during hospitalisation.

Results

Discussion

Conclusion