Differences in episode-based care costs for multidetector computed tomographic coronary angiography versus myocardial perfusion imaging for the diagnosis of coronary artery disease

J Med Econ. 2008;11(2):327-40. doi: 10.3111/13696990802134291.

Abstract

Background: Multidetector computed tomography (MDCT) is a novel method for diagnosis and prognosis of coronary artery disease (CAD). The opportunity costs that favour MDCT over other CAD diagnostic methods is currently unknown.

Methods: This study used an episodes of care cost model based on epidemiologic and economic data evaluating individuals without known CAD undergoing MDCT or myocardial perfusion scintigraphy (MPS). It was a multicenter retrospective database review of medical and pharmacy-related claims linked by episodes of care from 2002 to 2005. CAD-related episodes of care costs were examined 1-year downstream for patients after initial MDCT that were matched to patients who underwent MPS.

Results: After adjustment for patient factors, 1-year total CAD-related episodes of care costs for MDCT were 16.4% lower than MPS, by an average of $682 (95% confidence interval $14, $1,350) per patient. While costs per CAD-related episode were similar between MDCT and MPS groups ($4,284 vs. $4,277, p=0.08).

Conclusions: Patients without known CAD who undergo MDCT as an initial diagnostic test, compared to MPS, incurred fewer CAD-related episodes of care and lower overall CAD-related costs.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Comorbidity
  • Coronary Angiography / economics*
  • Coronary Artery Disease / diagnosis*
  • Coronary Circulation
  • Diagnostic Imaging / economics
  • Episode of Care*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Perfusion Imaging / economics*
  • Retrospective Studies
  • Tomography, X-Ray Computed / economics
  • Tomography, X-Ray Computed / methods*