ABSTRACT
Aim: This study compares the outcomes of patients who receive an implantable loop recorder (ILR) for unexplained syncope to a control group without the diagnostic device in German claims data. Methods and materials: Patients with ILR were matched to a control group based on prior syncope events, age, gender and Charlson Comorbidity index (CCI). Survival, syncope hospitalizations, treatment and costs were compared. Results/conclusion: Four hundred and twelve ILR patients were matched with controls, mean age was 68, mean CCI was 2.7, 42% females. ILR patients lived on average 1.2 years longer than patients in the control group. Twenty-five percent of ILR patients received a therapeutic device compared with 5% in the control group. ILRs might help to diagnose and treat patients with positive impact on survival.
Subject(s)
Syncope , Aged , Electrodes, Implanted , Female , Humans , Male , Syncope/diagnosis , Syncope/therapyABSTRACT
Aim: This study evaluated the occurrence and associated costs of pacemaker complications in Germany from 2010 to 2013. Patients & methods: Patients with a de novo or replacement implantation of a single or dual chamber pacemaker between 2010 and 2013 were followed for 12 months post-implant using German health insurance claims data. A case-control analysis was performed using propensity score matching to estimate the costs of complications. Results: Out of 12,922 implanted patients, 12.0% had a complication in the year following the implant. Complications related to lead and pocket were found in 10.2% of all implanted patients; infections occurred in 1.7% patients. Healthcare costs up to 36 months post complication were on average 4627 higher than for pacemaker patients without a complication. Conclusion: Pacemaker complications are common and represent a burden for patients and healthcare systems generating substantial costs. Most of the pacemaker complications involved the pacing lead or pacemaker pocket.
Subject(s)
Bradycardia/therapy , Pacemaker, Artificial/adverse effects , Ambulatory Care/economics , Ambulatory Care/statistics & numerical data , Bradycardia/economics , Case-Control Studies , Cost of Illness , Female , Germany , Health Care Costs , Health Expenditures , Hospitalization/economics , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Outcome Assessment, Health Care/economics , Pacemaker, Artificial/economics , Patient Acceptance of Health Care/statistics & numerical data , Postoperative Complications/economics , Propensity Score , Reoperation/economics , Reoperation/statistics & numerical data , Retrospective StudiesABSTRACT
AIM: Estimate incidence and costs of cardiac device infections (CDIs) in Germany. MATERIALS & METHODS: Patients had an implantable cardioverter defibrillator implanted over 2010-2013 and were followed to December 2014 using German health insurance claims data. A case-controlled analysis was performed using propensity score matching methods. RESULTS: Risk of CDI 12 months post-implant was 3.4% overall, either 2.9% for de novo procedures versus 4.4% for replacement procedures. Mean 3-year incremental expenditure per patient for patients with CDI compared with controls was 31,493 for de novo implant patients and 33,777 for replacement patients. Mean incremental expenditure was 59,419 per patient with a major infection. CONCLUSION: CDIs are highly expensive to manage, reinforcing the need for strategies to reduce their occurrence.
