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What is the cost of discussing patients in Heart Team in the Portuguese National Health System?
Session:
Posters (Sessão 1 - Écran 7) - Saúde Digital e Economia da Saúde
Speaker:
Carolina Pereira Mateus
Congress:
CPC 2023
Topic:
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.4 Non-cardiac Surgery/Pre-surgical Assessment
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Carolina Pereira Mateus; Miguel Santos; Sérgio Bravo Baptista; Márcio Madeira; Marta Marques; Inês Fialho; Mariana Passos; Joana Lopes; Marco Beringuilho; Inês Miranda; Filipa Gerardo; Pedro Farto e Abreu; José Neves; Carlos Morais
Abstract
<p><strong>Introduction:</strong><br /> The Heart Team (HT) concept was first used formally during the SYNTAX trial, published in 2009. While the concept of the HT is good and endorsed in the guidelines, it keeps a multidisciplinary team of specialists away from clinical tasks during the meeting time. Our<br /> purpose was to determine the cost per patient of a HT discussion, since this has not been described for the Portuguese National Health Service.</p> <p><strong>Methods:</strong><br /> Using the prospective database of a HT consisting of a Cardiology Department of a non-surgical center with around 1,500 ward and 250 cardiac ICU admissions per year, and its referral Cardiac Surgery, we determined the number of patients (pts) discussed, the time per patient discussed, and determined the cost per patient in 1,000 consecutive patients discussed. The HT at our center is usually composed of four doctors: clinical cardiologist, interventional cardiologist (IC), cardiac imaging specialist and the cardiac surgeon. Each meeting is prepared by an IC in advance. We considered the standard public hospital medical wage (2.746,24€ per month, 40h per week).</p> <p><strong>Results:</strong><br /> From January 2018 to December 2021, 1,020 patients were discussed in 69 HT meetings. Each meeting lasts 90 minutes. The interventional cardiologist takes around 3 hours to prepare each meeting and update the database. This yields a mean number of 14.8 patients discussed per meeting, with 6.1 minutes each. Considering the value of 3 hours of the IC (51.6€) plus the 90 minutes of four doctors meeting (103.2€), the whole meeting cost is 154.8€. Thus, the cost per patient discussed was 10.47€.</p> <p><strong>Conclusions:</strong><br /> In the Portuguese National Health Service, the cost per patient discussed in Heart Team is very low, making it one of the most cheapest and effective strategies for complex surgical cardiac patient management.</p>
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