Cost savings associated with an MRI based strategy in suspected severe mitral regurgitation
https://doi.org/10.1186/1532-429X-18-S1-O134
© Uretsky et al. 2016
Published: 27 January 2016
Keywords
Background
Recent studies have shown that echocardiography and MRI are often discordant when assessing the severity of mitral regurgitation (MR), with echocardiography often overestimating severity of mitral regurgitation compared to MRI (1). This is particularly true among patients who underwent mitral valve surgery based on echocardiographic assessment and the current ACC/AHA recommendations for valvular disease. These findings not only have potential impact on patient management it also has an impact on the healthcare costs associated with mitral valve surgery.
Methods
We prospectively enrolled 115 (61 ± 14 yrs, male 67%) patients with MR in a multicenter trial that underwent evaluation with both echocardiography and MRI. Each echocardiogram and MRI study was assessed for the severity of MR. Appropriateness of surgery was determined based on the ACC/AHA recommendations. The cost of mitral valve surgery was estimated conservatively as $30,000 based on prior publications (2). The cost of echocardiography ($264.48) and MRI ($431.80) was based on Medicare part B reimbursement.
Results
Among the 115 patients, 40 (35%) patients underwent indicated mitral valve surgery based on echocardiographic evaluation of MR severity and the ACC/AHA guidelines, with 93% having a class I indication and 7% having a class IIa indication. Of the 40 patients who underwent mitral valve surgery, 14 (35%) had a class I indication by MRI and 26 (65%) did not have an indication for mitral valve surgery. Based on cost estimates, an MRI based strategy would of resulted in a savings of $762,728 in our study cohort (Table 1).
Conclusions
Cost differences between an echocardiography based strategy vs. an MRI based strategy
Echocardiography based strategy | MRI based strategy | |
|---|---|---|
Echocardiography | $10,739.20 | $10,739.20 |
MRI | $17,272.00 | |
Surgery | $1,200,000 | $420,000 |
Total Costs | $1,210,739.20 | $448,011.20 |
Authors’ Affiliations
References
- Uretsky S, et al: Discordance between echocardiography and MRI in the assessment of mitral regurgitation severity: a prospective multicenter trial. J Am Coll Cardiol. 2015, 65 (11): 1078-88. Mar 24View ArticlePubMedGoogle Scholar
- Suri RM, et al: Improving affordability through innovation in the surgical treatment of mitral valve disease. Mayo Clinic proceedings. 2013, 88 (10): 1075-84.View ArticlePubMedGoogle Scholar
- Gammie JS, et al: Trends in mitral valve surgery in the United States: results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg. 2009, 87 (5): 1431-7. MayView ArticlePubMedGoogle Scholar
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
