The work was carried out at the Department of Medicine, Kristianstad Hospital, Kristianstad, Sweden.
Hospital utilization and costs for spinal cord stimulation compared with enhanced external counterpulsation for refractory angina pectoris
Article first published online: 31 OCT 2011
© 2011 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 19, Issue 1, pages 139–147, February 2013
How to Cite
Bondesson, S. M., Jakobsson, U., Edvinsson, L. and Hallberg, I. R. (2013), Hospital utilization and costs for spinal cord stimulation compared with enhanced external counterpulsation for refractory angina pectoris. Journal of Evaluation in Clinical Practice, 19: 139–147. doi: 10.1111/j.1365-2753.2011.01784.x
- Issue published online: 25 JAN 2013
- Article first published online: 31 OCT 2011
- Accepted for publication: 30 June 2011
- enhanced external counterpulsation;
- hospital utilization;
- refractory angina pectoris;
- spinal cord stimulation
Rationale, aims and objectives The aim of this study was to compare acute hospital utilization and costs for patients with refractory angina pectoris undergoing spinal cord stimulation (SCS) versus enhanced external counterpulsation (EECP).
Method Seventy-three persons were included in this register study. The acute hospital utilization and costs for SCS and EECP were followed over a period from 12 months before treatment to 24 months after treatment using Patient Administrative Support in Skåne for publicly organized care.
Results SCS was significantly more expensive than EECP (P < 0.001). Both SCS and EECP entailed fewer days of hospitalization for coronary artery disease in the 12-month follow-up compared with the 12 months preceding treatment. Patients treated with EECP showed an association between reduced hospital admissions and an improved Canadian Cardiovascular Society classification class compared with 1 year before treatment. A significant reduction in cost was seen in both the SCS group (P = 0.018 and P = 0.001, respectively) and the EECP group (P = 0.002 and P = 0.045, respectively) during 12 and 24 months of follow-up compared with before treatment. There were no significant differences between the groups for hospitalization days or admissions, including costs, at the different follow-ups.
Conclusions Cost-effective treatment modalities such as SCS and EECP are valuable additions to medical and revascularization therapy in patients with refractory angina pectoris. Pre-existing conditions and the patient's preferences should be taken in consideration when clinicians choose between treatments for this group of patients.