Policy, Payment & Practice -> Health Economics D-PO05 - Poster Session V (ID 39) Poster

D-PO05-209 - Trends Of Invasive Electrophysiological Procedures In Patients Admitted With Syncope: Health Care Planning Implications (ID 620)

 R. Gupta: Nothing relevant to disclose.


Background: Syncope is a common clinical presentation accounting for 3% of all emergency room visits, with atleast once in a lifetime symptom in 40% patients with high recurrence rates. According to the Medicare cost-to-charge ratios, annual cost of syncope related hospitalization estimated to be $2.4 billion in 2000.
Objective: We aimed to determine trends of invasive electrophysiological (EP) procedures in patients admitted with syncope in United States from 2002 to 2013.
Methods: We analyzed data from Healthcare Cost and Utilization Project of Agency for Healthcare Research and Quality, Rockville, MD from years 2002-2013. All patients were identified by International Classification of Diseases, 9thRevision, Clinical Modification.
Results: Between the years 2002 and 2013, we identified 625,338 (national estimate of 3,077,193) hospital admissions for syncope, with highest admission in initial years and a steady decline over later half. EP study (1.72%) was the most common invasive EP procedure with a steady decline during the study period (Ptrend<0.001). The total cost for these admissions was $4.20 billion (national extrapolation $20.64 billion), initially increasing until 2006 and down-trending subsequently. Cost was primarily driven by invasive procedural needs, i.e. permanent pacemakers (OR 82.28), percutaneous coronary intervention (OR 54.36), implantable cardioverter defibrillator implantation (OR 45.72) and EP study (OR 10.57). Overall mortality rate was low (0.25%) with no significant trend.
Conclusion: Syncope related admission although associated with low mortality but continues to remain a substantial economic burden in our current healthcare system.