CABG costs 80 percent higher in U.S. than CANADA

Hospital Costs of Coronary Artery Bypass Graft Surgery in U.S. More
Than 80 Percent Higher in U.S. Than in Canada



CHICAGO - Although there are no differences in clinical outcome, the
in-hospital cost of coronary artery bypass graft surgery (CABG) in the
U.S. is 82.5 percent higher in the U.S. than in Canada, according to a
study in the July 11 issue of Archives of Internal Medicine, one of the
JAMA/Archives journals.



Cardiovascular disease is a leading cause of illness and death in the
U.S. and Canada, with an estimated direct cost in the U.S. of $209.3
billion in 2003, including $94.1 billion in in-hospital costs alone,
according to background information in the article. In 2000, more than
500,000 CABGs were performed in the U.S.



Mark J. Eisenberg, M.D., M.P.H., of Jewish General Hospital, Montreal,
and colleagues compared the outcomes and costs of treatment of 12,017
consecutive patients (4,698 U.S. and 7,319 Canadian patients)
undergoing CABG at five U.S. and four Canadian hospitals.



"In-hospital costs of treatment were substantially higher in the United
States than in Canada [an average cost of $20,673 vs. $10,373]," the
authors report. "After controlling for demographic and clinical
differences, length of stay in Canada was 16.8 percent longer than in
the United States; there was no difference in in-hospital mortality
[death]; and the cost in the United States was 82.5 percent higher than
in Canada."



"Coronary artery bypass graft surgery requires substantial resources
in Canada and the United States," the authors conclude. "However,
patients undergoing CABG at U.S. hospitals incur approximately twice as
much cost compared with those at Canadian hospitals, with little
difference in clinical outcome and despite shorter average LOS [length
of stay]. The difference in total in-hospital costs is almost equally
attributable to differences in direct and overhead costs between the
Canadian and U.S. hospitals. This cost differential primarily reflects
higher resource prices for products and labor and higher overhead costs
in the United States resulting from a nonsocialized medical system.
However, U.S. hospitals also appear to streamline services better to
reduce LOS, a strategy Canadian hospitals might emulate to further
reduce treatment costs."

(Arch Intern Med. 2005; 165:1506-1513.)

Editor's Note: This study was supported by an unrestricted research
grant from Pfizer, Inc., Groton/New London, Conn. Dr. Eisenberg is a
Senior Physician-Scientist of the Quebec Foundation for Health
Research, Montreal. Co-author Kristian B. Filion, B. Sc., was supported
by a Canadian Cardiovascular Outcomes Research Team Summer Studentship.
Co-author Louise Pilote, M.D., M.P.H., Ph.D., is a Physician-Scientist
of the Canadian Institutes of Health Research, Ottawa, Ontario.

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  • Re: Replacing Michelle
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  • Re: Replacing Michelle
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