DETERMINANTI DEI COSTI DIRETTI DELL'IMPIANTO DI PACEMAKER

Background. Pacemaker implantation is considered worldwide as the most important therapeutic regimen forpatients with heart conduction disturbances and arrhythmias. Previous findings have shown that pacmaker therapy is effective as well as expensive. This study was aimed at estimating the direct costs of the pacemaker implantation and considering some factors which could be associated with them. Materials and methods. 203 patients from Division of Cardiology, S. Matteo Hospital, Pavia, were enrolled between 1/1/1996 and 1/4/1997. Clinical, general, and demographic data were collected. The implantation costs were calculated; we then focused on the fixed and the so called specific cost, based on the total cost minus the value of the pacemaker device. Regression analyses (dependent variable the implantation cost and the cost of care) taking as independent variables clinical, demographic and social features were performed. Results. Results have shown an important role of age and diagnosys in determining the cost of implantation. A subgroup of patients (n = 53) was analyzed using questionnaires related to subjective well being as well as quality of life. A significantly different cost between patients having or not having psychological distress was found. Conclusion. Pacemaker implantation was confirmed to be an expensive procedure, however various factors may differently affects its cost.