EVOLVING COSTS OF LONG-TERM LEFT-VENTRICULAR ASSIST DEVICE IMPLANTATION

Background. To examine the long-term costs of implanting a left ventri cular assist device, we reviewed the initial hospitalization and outpa tient costs for 12 patients who received a vented electric left ventri cular assist device, and project-ed the first-year costs. Methods. We used the ratio-of-cost-to-charges method to measure hospital costs and payments for physician time. Mie examined time trends in the resource use of: 50 pneumatic left ventricular assist device recipients, using actuarial techniques and regression modeling. Results. The average ac tual cost of left ventricular assist device support is $221,313 over a n average of 9.5 months. if there had been mo Food and Drug Administra tion regulatory policy precluding hospital discharge before 30 days, t his value would have been $201,148. Based on this latter figure, the a verage predicted first-year cost is $219,139. The length of the intens ive care unit stay, one of the most costly components of care, decreas ed significantly over time. Conclusions. The high costs of left ventri cular assist device implantation are similar to those reported for car diac transplantation. Given their success in supporting survival, we a nticipate that these devices will be similarly cost-effective. However , further research is imperative to determine the cost-effectiveness o f these devices beyond the introductory phase, when costs, benefits, a nd Food and Drug Administration requirements have stabilized. (C) 1997 by The Society of Thoracic Surgeons.