Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Costs Associated with Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement in Korea

  • Suk Ho Sohn (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kyung Hwan Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Yoonjin Kang (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jae Woong Choi (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Seung Hyun Lee (Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Sung Ho Shinn (Shinn Sung Ho Cardiovascular Center) ;
  • Jae Suk Yoo (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cheong Lim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • Received : 2024.04.26
  • Accepted : 2024.07.31
  • Published : 2024.11.05
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Abstract

Background: This study compared the costs associated with transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in Korea by utilizing the National Health Insurance Service database. Methods: Between June 2015 and May 2019, 1,468 patients underwent primary isolated transfemoral TAVI, while 2,835 patients received primary isolated SAVR with a bioprosthesis. We assessed the costs of index hospitalization and subsequent healthcare utilization, categorizing the cohort into 6 age subgroups: <70, 70-74, 75-79, 80-84, 85-89, and ≥90 years. The median follow-up periods were 2.5 and 3.0 years in the TAVI and SAVR groups, respectively. Results: The index hospitalization costs were 41.0 million Korean won (KRW) (interquartile range [IQR], 39.1-44.7) for the TAVI group and 24.6 million KRW (IQR, 21.3-30.2) for the SAVR group (p<0.001). The TAVI group exhibited relatively constant index hospitalization costs across different age subgroups. In contrast, the SAVR group showed increasing index hospitalization costs with advancing age. The healthcare utilization costs were 5.7 million KRW per year (IQR, 3.3-14.2) for the TAVI group and 4.0 million KRW per year (IQR, 2.2-9.0) for the SAVR group (p<0.001). Healthcare utilization costs were higher in the TAVI group than in the SAVR group for the age subgroups of <70, 70-74, and 75-79 years, and were comparable in the age subgroups of 80-84, 85-89, and ≥90 years. Conclusion: TAVI had much higher index hospitalization costs than SAVR. Additionally, the overall healthcare utilization costs post-discharge for TAVI were also marginally higher than those for SAVR in younger age subgroups.

Keywords

Acknowledgement

The authors thank the Medical Research Collaborating Center of Seoul National University Hospital for the statistical support.

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