Analysis of health outcomes in acute myocardial infarction: A value-based healthcare approach
DOI:
https://doi.org/10.15649/cuidarte.3796Keywords:
Acute Myocardial Infarction, Value-Based Health Care, Hospital Costs, Outcome AssessmentAbstract
Highlights
- The adoption of the prospective global payment (PGP) model represents a significant improvement in the health outcomes and cost-effectiveness of healthcare.
- The PGP model reduces hospitalization days and costs while maintaining or improving health outcomes for acute myocardial infarction (AMI) patients.
- Patients who died had longer hospital stays, especially women and those with ST-segment elevation.
- This research addresses a critical gap in evidence on healthcare payment models and health outcomes in Latin America.
Introduction: Understanding the impact of value-based healthcare and various healthcare payment models on the health outcomes of patients with acute myocardial infarction (AMI) is pivotal for guiding clinical strategies and decisions. Objective: To compare health outcomes and costs associated with healthcare for AMI patients under insurance prospective global payment (PGP) and fee-for-service models. Materials and Methods: A retrospective cohort study encompassing AMI patients was conducted from 2021-2023. Convenience sampling of participants over 18 years of age diagnosed with type 2 myocardial infarction was conducted. Analysis was based on Colombian healthcare system payment models: PGP and fee-for-service. Results: The study involved 2134 patients, 657 (31%) under PGP and 1477 (69%) under fee-for-service. Length of hospital stay was associated with the payment model (coefficient -0.68, CI 95%: 0.40 to 0.98, p=0.037). Payment models also correlated with costs (845 USD, CI 95%: 87.92 to 1601; p=0.02 ). In-hospital mortality is not associated with either of the two contracting models. Quality-adjusted life years (QALYs) totaled 1.6 over a 2-year follow-up. Discussion: It is evident that throughout the care cycle at the Center of Excellence for Acute Myocardial Infarction, there is added value for patients with the PGP model, as the costs are lower and health outcomes comparable to the fee-for-service model. Conclusions: The findings of this study underscore the importance of understanding the relationship between value-based healthcare, different healthcare payment models, and health outcomes in AMI patients.
How to cite this article: Bermon Anderson, Licht-Ardila Maricel, Manrique-Hernández Edgar Fabián, Hurtado-Ortiz Alexandra. Analysis of health outcomes in acute myocardial infarction: A Value-Based Healthcare approach. Revista Cuidarte. 2024;15(2):e3796. https://doi.org/10.15649/cuidarte.3796
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