Shift to Same-Day Cardiac Procedure Could Cut $300 Million Annually

US hospitals could save $300 million a year by shifting just 30% of percutaneous coronary intervention (PCI) procedures to transradial, same-day discharge procedures—a pathway that is also associated with fewer complications than transfemoral interventions. Researchers published their findings in JACC: Cardiovascular Interventions.

“We now have identified a mechanism for hospitals to improve their efficiency, lower costs, and which is associated with improved PCI outcomes simultaneously,” said lead study author Amit P Amin, MD, MSc, assistant professor of medicine at Washington University School of Medicine. “Our data show there is a tremendous potential to... achieve a ‘win-win’ for both patients and hospitals. A cardiac procedure to treat narrowing of the arteries in the heart, PCI costs the United States roughly $10 billion annually. 

The adjusted cost associated with transradial access and same-day discharge was $13,389, researchers reported. In comparison, transfemoral access with overnight stay had an associated cost of $17,076, or $3689 more per PCI procedure.

By shifting practice by 30% toward same-day transradial procedures, a hospital performing 1000 elective PCIs annually could save nearly $1 million, researchers reported. Collectively, hospitals across the country could lower costs by nearly $300 million.

A related editorial addressed concern over selection bias in the analysis, pointing out that patients undergoing transradial, same-day discharge PCIs are typically the lowest risk and represented only 1.2% of the study population. 

“Although the true (unbiased) cost differences in this National Cardiovascular Data Registry cohort are unknowable, this author’s opinion is that the cost differences estimated by the authors experience only a moderate amount of bias and that the findings are significant, although perhaps smaller in magnitude than those estimated by the authors,” wrote Joseph A Ladapo, MD, PhD, of the David Geffen School of
Medicine at UCLA. —Jolynn Tumolo