Heart surgery more costly for older women

Heart bypass surgery is more expensive for older women than it is for other patient groups, New York researchers report in the Annals of Surgery.

The results also indicate that bigger hospitals have higher hospitalization costs for bypass surgery, but as the number of cases performed at a given hospital increases, the costs drop markedly.

To investigate factors associated with bypass surgery costs, Dr. Shadi Saleh and associates at the State University of New York at Albany analyzed data from New York State's Cardiac Surgery Reporting System and from a number of other relevant sources.

The study group consisted of 12,016 New York state residents who underwent heart bypass surgery in a New York State hospital and were discharged in 2003. Patient and hospital characteristics were included in the analysis.

"Findings revealed that selected demographic characteristics, including older age, female gender, and being black, were associated with higher costs," Saleh and colleagues report.

A number of clinical factors also increased costs, such as a reduced pumping capacity of the heart, a longer time between heart attack and heart surgery, more severe heart disease, prior heart surgery, and the presence of other serious diseases.

As noted, larger hospitals were associated with higher costs. A higher annual number of heart bypass operations was associated with decreased costs.

Hospitals should explore ways to reduce the impact of hospital and patient characteristics to the extent possible in order to contain costs, Saleh's team says.

SOURCE: Annals of Surgery, February 2009.