As heart disease remains the leading cause of death in the U.S., technological advances pertaining to the treatment and prevention of heart disease, such as drug-eluting stents (DES), have led to better patient care, but also have added to the rise of healthcare expenditures, according to the 33rd annual trend report released by the Centers for Disease Control and Prevention (CDC).
"Technology continues to transform the medical care system as new and existing types of tests, imaging, procedures, devices and machinery are increasingly utilized but at a substantial cost," the report stated.
The rate of hospital discharges per 100 population increased three-fold for visits to physician offices and hospital outpatient departments where MRI, CT or PET scans were ordered. In addition, the number of these advanced imaging exams ordered increased four-fold, while costs associated with them have skyrocketed from $6.9 billion in 2000 to $14.1 billion in 2006 (Medicare Part B spending).
In addition, from 1988 to 1994 and 2003 to 2006, administration of statin drugs increased 10-fold, from 2 percent to 22 percent, respectively.
Due to the significant number of Americans living with heart disease or other types of cardiac problems, cardiac-related procedures, such as PCI and CABG, have consumed the majority of hospitalization costs, according to the report.
The amount spent on PCI procedures jumped from close to $6 billion in 1999 to almost $13 billion in 2006. Costs associated with cardiac pacemakers, cardioverters and defibrillators rose from almost $3 billion in 1999 to more than $8 billion in 2006, according to the report.
After evaluating data for PCI procedures using a bare-metal stent, a DES and no stent between 1996 and 2006, the report showed that PCI discharges without the use of a stent declined by 84 percent.
In comparison, in 1996, two-thirds of PCI discharges used no stent during the procedure.
After the adoption of the DES in 2003, hospital discharges in 2004 with use of a such a device were 69 percent and these numbers reached 77 percent by 2006.
According to the report, the number of younger people receiving DES doubled during the time period studied. The CDC expressed concern that the adoption and use of DES might have happened too quickly, as more recent studies have indicated their association with thrombosis.
"The dilemma is how to best target new technologies, given that they are often more expensive than older options and their impact on broader and more diverse population subgroups is not fully known until they are more widely used and studied over longer periods," the report stated.
In addition, the report found that national healthcare costs reached $2.2 trillion in 2007, a 6 percent increase from 2006. According to the CDC, hospitalization costs soak up 31 percent of this expenditure, while 10 percent was spent on prescription drugs.
The report was prepared by the Secretary of the Department of Health and Human Services (HHS).