MECHANICAL VENTRICULAR ASSISTANCE - AN ECONOMICAL AND EFFECTIVE MEANSOF TREATING END-STAGE HEART-DISEASE

Background. Heightened awareness of medical costs has escalated critic ism toward expensive medical therapy. Methods. The use of ventricular assistance devices (VADs) at Pennsylvania State University as a bridge to transplantation was reviewed. Records of 43 patients listed as sta tus I from July 1991 to July 1994 were compared. Results. This analysi s demonstrated that for all patients treated with the intent to transp lant, those who were bridged with a VAD exhibited a trend toward an im proved transplantation rate (92% versus 68%) and a significantly great er rate of discharge from the hospital (92% versus 55.4%; p = 0.023) t han the medically managed patients. Although overall charges and costs were higher in VAD-supported patients, this was related to significan tly longer pretransplantation hospitalization. When normalized to dail y costs and charges, this discrepancy in expenses was eliminated. Conc lusions. The superior rate of discharge at equitable daily costs and c harges for the VAD patients draws continued enthusiasm toward use of t hese devices as a bridge to transplantation. Furthermore, development of outpatient care for VAD-supported patients and continued advances i n the use of these devices may further reduce the cost of managing the se critically ill patients.