Statistical Brief #128
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April 2012
David I. Auerbach, Ph.D., Jared Lane Maeda, Ph.D.,
M.P.H., and Claudia Steiner, M.D., M.P.H.
Introduction
Coronary or cardiac stents are used in surgical procedures called percutaneous transluminal coronary angioplasty (PTCA), also known as balloon angioplasty. These procedures are intended to reduce the risk of heart attacks or other complications stemming from coronary heart disease that involves the blockage of the arteries. In a PTCA, a catheter is inserted through an artery in the leg and drawn into the area of the blockage. The artery is opened with a balloon, and a stent is often used to maintain the opening and prevent the artery from reclosing (restenosis). Stents have been shown to reduce restenosis and the need to repeat the procedure.1
Drug-eluting stents, which were introduced in the early 2000s, release a drug that is intended to prevent restenosis. Drug-eluting stents can effectively reduce the rate of restenosis in some cases, but are considerably more costly resulting in some controversy over their cost-effectiveness.2 A more recent study of drug-eluting stents in heart disease patients 65 years and older demonstrated lower mortality and less heart attacks as compared to non-drug-eluting stents.3
This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) on hospitalizations involving cardiac stents. Virtually all cardiac stent procedures, as reported in this Brief, are associated with a balloon angioplasty (PTCA).4 Specifically, variation in hospitalizations by patient demographics, hospital, and payer characteristics in 2009 and utilization trends over time are discussed, in some cases separately for drug-eluting and non-drug-eluting stents. All differences between estimates noted in the text are statistically significant at the 0.05 level or better.
Findings
In 2009, there were 644,240 hospital stays that involved the implantation of a cardiac stent with a balloon angioplasty (table 1). Those hospitalizations averaged about 3 days in length, incurred a mean cost of $18,560, and amounted to almost $12 billion nationally. Drug-eluting stents were used in roughly three-fourths of cases and had a one-day shorter average length of stay and lower average cost per hospital stay compared to discharges with a non-drug-eluting stent.
Introduction
Coronary or cardiac stents are used in surgical procedures called percutaneous transluminal coronary angioplasty (PTCA), also known as balloon angioplasty. These procedures are intended to reduce the risk of heart attacks or other complications stemming from coronary heart disease that involves the blockage of the arteries. In a PTCA, a catheter is inserted through an artery in the leg and drawn into the area of the blockage. The artery is opened with a balloon, and a stent is often used to maintain the opening and prevent the artery from reclosing (restenosis). Stents have been shown to reduce restenosis and the need to repeat the procedure.1
Drug-eluting stents, which were introduced in the early 2000s, release a drug that is intended to prevent restenosis. Drug-eluting stents can effectively reduce the rate of restenosis in some cases, but are considerably more costly resulting in some controversy over their cost-effectiveness.2 A more recent study of drug-eluting stents in heart disease patients 65 years and older demonstrated lower mortality and less heart attacks as compared to non-drug-eluting stents.3
This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) on hospitalizations involving cardiac stents. Virtually all cardiac stent procedures, as reported in this Brief, are associated with a balloon angioplasty (PTCA).4 Specifically, variation in hospitalizations by patient demographics, hospital, and payer characteristics in 2009 and utilization trends over time are discussed, in some cases separately for drug-eluting and non-drug-eluting stents. All differences between estimates noted in the text are statistically significant at the 0.05 level or better.
Findings
In 2009, there were 644,240 hospital stays that involved the implantation of a cardiac stent with a balloon angioplasty (table 1). Those hospitalizations averaged about 3 days in length, incurred a mean cost of $18,560, and amounted to almost $12 billion nationally. Drug-eluting stents were used in roughly three-fourths of cases and had a one-day shorter average length of stay and lower average cost per hospital stay compared to discharges with a non-drug-eluting stent.
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