An inpatient cardiomyopathy unit (CMU) may offer a lower cost and higher contribution margin alternative for the management of advanced heart failure (HF) patients, requiring hemodynamic monitoring without other major inpatient procedures, according to a retrospective review in the June issue of the Journal of Cardiac Failure.
Douglas Gregory, PhD, from Cardiovascular Clinical Studies in Boston, and colleagues from the divisions of cardiology and medicine at Tufts Medical Center in Boston, analyzed the relative costs and revenues of the Tufts Medical Center CMU, a recent change for grouping and managing advanced decompensated heart failure patients.
The researchers selected a retrospective sample of all patients diagnosed with HF, who had undergone pulmonary artery catheterization with no other hospitalization procedures, admitted to Tufts between 2000 and 2006. They used regression models to estimate the cost for the intervention group and controls, and propensity analysis to test for selection bias in the comparison groups.
Gregory and colleagues identified 114 hospitalizations meeting these criteria. Patients in the CMU group were well-balanced compared with controls with respect to demographic and clinical variables.
The authors estimated direct medical costs for CMU and control groups were $11,817 and $17,236, respectively. They found a similar pattern of cost differentials was displayed among propensity-matched sample groups.
Overall, Gregory and colleagues reported the net revenue was $12,609 and $15,627 in the CMU and control groups, respectively.