Cost Effectiveness Analysis and Payment Policy Recommendation-Population-Based Survey with Big Data Methodology for Readmission Prevention of Patients with Paroxysmal Supraventricular Tachycardia treated with Radiofrequency Catheter Ablation.

Abstract

Recurrence of paroxysmal supraventricular tachycardia (PSVT) has been reported to be lower in patients treated with radiofrequency catheter ablation (RFCA) than in those who are not. Few population-based surveys have stated the cost-effectiveness related to this treatment. We, therefore, performed a nationwide retrospective study using National Health Insurance Research Database (NHIRD) data from 2001–2012 in Taiwan. The incidence of PSVT-related admissions was computed from patients’ first admission for a primary PSVT diagnosis. There were 21,086 patients hospitalized due to first-time PSVT, of whom 13,075 underwent RFCA, with 374 recurrences (2.86%). In contrast, 1751 (21.86%) of the remaining 8011 patients who did not receive RFCA, most of whom had financial concerns, experienced PSVT recurrence. The relative PSVT recurrence risk in those who did not receive RFCA was 7.6 times (95% CI: 6.67–8.33) that of those who did undergo RFCA. In conclusion, the PSVT recurrence rate was much higher in patients who did not receive RFCA at their first admission. Furthermore, RFCA proved cost-effective, with the ratio of the incremental cost-effectiveness ratio (ICER) and gross domestic product (GDP) being only 1.15. To prevent readmission and avoid incremental cost, the authority could provide a financial supplement for every patient so that the procedure is performed, reducing the PSVT-recurrence life-years (disease-specific DALY).