I costi dei pazienti sottoposti a impianto di pacemaker

The pacemaker implantation is actually considered all over the world as an essential and effective device in many heart diseases. Nevertheless, few economic evaluation has been conducted in terms of costing and alternative pacemaker devices and implantation (e.g. single vs. dual cjamber pacing), none of which in Italian settings. we present here a cost identification analysis carried out in a large University Hospital in Italy. METHODS: By means of a questionnaire, the study has determined the total treatment costs (full hospital costs), from baseline diagnostic procedures to follow-up, of 203 patients enrolled from 1/1/1996 to 1/4/1997 at the Cardiology Department of S. Matteo Hospital, Pvia. The costs per patient have been differentiated by treatment phase (baselibe, implantation, follow-up), type of pacemaker device, hospital care (inpatient vs. day hospital) and Diagnostic Related Group to assess possible cost differences. RESULTS: Average cost per patient resulted 9,230,000 Italian Lire (ItL) in 1996. Te surgical procedure cost was 92% of the total costs, and the pacemaker device alone was 61.8%. The study found a considerable variation of costs per patient associated to the type of pacemaker device and the number of catheters implanted (range: ItL. 8,084,000 for single chamber pacing to ItL. 11,314,000 for dual chamber pacing). A comparative analysis with the Regional and National DRG tariffs showed positive economic results for the hospital studied and the need for more realistic prices.