Cardiac revascularization surgery in the elderly: An evidence-based health economic approach

CARDIAC REVASCULARIZATION SURGERY IN THE ELDERLY: AN EVIDENCE-BASED HEALTH ECONOMIC APPROACH    Background: Increasing prevalence of chronic disease in the context of an ageing society has led many to question the value of cardiac revascularization surgery and associated intensive care in elderly (octogenarian) populations. However societal expectations of improved technology and its likely impact on longevity and improved quality of life suggest there is a demand for cardiac surgery in this population. Elderly people are more likely to hold private health insurance, therefore the cost (in terms of waiting time) is likely to be low.     Objectives: This presentation will consider the value of cardiac revascularization surgery from a health economic perspective, including the various perspectives of patient, family/significant others, providers, healthcare sector and society.     Method: A theoretical evidence-based health economic model will be presented that is relevant to the evaluation of cardiac surgery in an elderly population. This will be combined with a review of the literature and existing data sources as evidence-based inputs into the development of an economic model to assess cost effectiveness in terms of cost per quality adjusted life year saved. Studies included will be recent published trials (post 2010) where costs and/or quality of life outcomes have been compared between cardiac surgery and conservative management in an elderly (80+ years) population.     Results/Conclusion: Recent literature and study results will be reviewed against the theoretical health economic model. Where evidence and/or data exist that meet inclusion criteria for the economic analysis these will be summarised in the model. Where gaps in evidence exist these will be highlighted, including appropriate strategies to address data deficiencies.     A/Prof Jennifer Watts  Health Economics  Faculty of Health   Deakin University