Economic burden of functional and organic mitral valve regurgitation
Résumé
BACKGROUND: Very little is known about the costs of mitral regurgitation (MR) in Europe. AIM: To evaluate the cost of MR from a French National Payer perspective, based on annual costs of surgical and non-surgical patients. METHODS: A 12-month retrospective population-based analysis of patient demographics, outcomes and acute hospital and post-discharge resource utilizations, extracted from the 2009 French Medical Information System. RESULTS: A total of 19,868 patients with MR were identified. Surgical group (n=4099): index hospitalization length of stay (LOS), 17+/-14.7 days; patients discharged to rehabilitation, 72% (LOS 23+/-16 days); 12-month rehospitalization rate, 25%; total cost per surgical patient, euro24,871+/-13,940 (ranging from euro21,970+/-11,787 for mitral valve repair [n=2567, 62.6%] to euro29,732+/-15,796 for mitral valve replacement). Non-surgical group (n=15,769): number of hospitalizations over 12 months, 3.1+/-1.5 (LOS 23.5+/-20.4 days); admitted to rehabilitation, 24% (LOS 38.8+/-37.6 days); total cost per patient, euro12,177+/-10,913 (varying between euro9957+/-9080 and euro13,538+/-11,692 for those without and with heart failure [HF], respectively). The total observed cost for 19,868 MR patients over 12 months was euro292.8 million: surgical group, euro100.8 million; medical group euro192.0 million. Patients with MR and HF who were managed medically consumed 45% (euro132.3 million) of the overall annual cost of MR. CONCLUSION: The costs of care associated with MR are highly heterogeneous. There are significant differences in costs and resources used between the surgical and medical MR subgroups, with further differences depending on type of surgery and presence of HF.