Cardiovascular Health Care Economics (Contemporary Cardiology)

An illuminating and timely synthesis of methodological and clinical studies showing how medical costs can be established, how the value of clinical outcomes can be assessed, and how difficult choices can be rationally made. The methodological chapters review the conceptual and practical issues involved in estimating and interpreting health care costs, making health status and utility assessments, and statistically analyzing cost-effectiveness and clinical trials. The clinical chapters apply these methods to the major clinical areas of cardiology-primary prevention of coronary artery disease, acute coronary syndromes, angioplasty vs coronary bypass surgery, CABG vs medicine, congestive heart failure, arrhythmias, and cardiac surgery. Additional chapters consider the use of economic studies for policy purposes and the future of Medicare under a balanced budget in an aging America. Given the limited ability of government to fund health care and the staggering cost of cardiovascular disease to society-an estimated $351.8 billion for 2003 in direct medical costs and lost productivity-critical choices must be made to reduce the burden of cardiovascular health care and minimize its collateral losses. In an illuminating synthesis of methodological and clinical studies, Cardiovascular Health Care Economics shows how costs can be established, how the value of clinical outcomes can be assessed, and how difficult choices can be rationally made. In the methodological chapters, well-known experts review the conceptual and practical issues involved in estimating and interpreting health care costs, making health status and utility assessments, and statistically analyzing cost-effectiveness and clinical trials. The clinical chapters apply these methods to the major clinical areas of cardiology-primary prevention of coronary artery disease, acute coronary syndromes, angioplasty vs coronary bypass surgery, CABG vs medicine, congestive heart failure, arrhythmias, and cardiac surgery. Additional chapters consider the use of economic studies for policy purposes and the future of Medicare under a balanced budget in an aging America. Comprehensive and timely, Cardiovascular Health Care Economics offers today's cardiologists, administrators, policymakers, and investigators an enlightening introduction and up-to-date reference to cardiovascular health care economics, as well as a sound basis for making the good choices that will assure continued access to high-quality health care in the decades to come. Front Matter....Pages i-xii Front Matter....Pages xiii-xiii Nonfederal US Hospital Costs....Pages 1-14 Estimating the Costs of Cardiac Care Provided by the Hospitals of the US Department of Veterans Affairs....Pages 15-29 Estimating the Costs of Health Care Resources in Canada....Pages 31-44 US Physician Costs....Pages 45-62 Indirect Health Care Costs....Pages 63-79 Health Status Assessment....Pages 81-99 Utility Assessment....Pages 101-110 Introduction to Cost-Effectiveness Analysis....Pages 111-121 Cost-Effectiveness Analysis Alongside Clinical Trials....Pages 123-156 Front Matter....Pages N1-N1 Costs of Care and Cost-Effectiveness Analysis....Pages 157-172 Economics of Therapy for Acute Coronary Syndromes....Pages 173-185 Cost-Effectiveness of Percutaneous Coronary Interventions....Pages 187-221 Economic Comparisons of Coronary Angioplasty and Coronary Bypass Surgery....Pages 223-232 Costs of Coronary Artery Surgery and Cost-Effectiveness of CABG vs Medicine....Pages 233-248 Costs of Care and Cost-Effectiveness Analysis....Pages 249-258 Congestive Heart Failure....Pages 259-283 Current Economic Evidence Using Noninvasive Cardiac Testing....Pages 285-301 Cost-Effective Care in the Management of Conduction Disease and Arrhythmias....Pages 303-328 Comparing Cost-Utility Analyses in Cardiovascular Medicine....Pages 329-356 Beyond Heart Disease....Pages 357-363 Front Matter....Pages N1-N1 Using Economic Studies for Policy Purposes....Pages 365-387 Medicare, the Aging of America, and the Balanced Budget....Pages 389-416 Afterword....Pages 417-419 Back Matter....Pages 421-436