Causes of differences in the uptake of cardiac implantation electronic devices in Slovenia in comparison to other countries
, and | Jan 05, 2018
About this article
Article Category: Original scientific article
Published Online: Jan 05, 2018
Page range: 1 - 9
Received: Sep 06, 2016
Accepted: Sep 08, 2017
DOI: https://doi.org/10.2478/sjph-2018-0001
Keywords
© 2018 National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Figure 1
Comparison of the data on numbers of PMs and ICDs from national hospital discharge database with the data published in the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC).
| Slovenia | Austria | All UK England | Germany | Italy | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Year | EHRA | Hospitals | Diff | EHRA | Hospitals | Diff | EHRA | Hospitals | Diff | EHRA | Hospitals | Diff | EHRA | Hospitals | Diff |
| Pacemakers | |||||||||||||||
| 2008 | 1100 | 586 | -88% | 7570 | 7690 | 2% | 40570 | 37734 | -8% | 98300 | 89194 | -10% | 61300 | 62220 | 2% |
| 2009 | 935 | 652 | -43% | 7930 | 7500 | -6% | 39850 | 42701 | 7% | 102177 | 92215 | -11% | 63000 | 62215 | -1% |
| 2010 | 1153 | 602 | -92% | 7712 | 7589 | -2% | 37194 | 45636 | 18% | 103423 | 94659 | -9% | 63400 | 62202 | -2% |
| 2011 | 1295 | 604 | -114% | 7810 | 7870 | 1% | 38239 | 50540 | 24% | 106953 | 96013 | -11% | 63100 | 62141 | -2% |
| 2012 | 1333 | 667 | -100% | 7870 | 7950 | 1% | 38770 | 0 | 106567 | 96403 | -11% | 61300 | 62098 | 1% | |
| 2008 | 96 | 103 | 7% | 1100 | 1104 | 0% | 7403 | 5086 | -46% | 21600 | 20948 | -3% | 18000 | 16554 | -8% |
| 2009 | 111 | 145 | 23% | 1290 | 1157 | -11% | 5077 | 5376 | 6% | 23574 | 22940 | -3% | 10500 | 15100 | 30% |
| 2010 | 101 | 176 | 43% | 1268 | 1176 | -8% | 5175 | 5344 | 3% | 25071 | 24422 | -3% | 11100 | 13933 | 20% |
| 2011 | 144 | 174 | 17% | 1805 | 1195 | -51% | 5404 | 5467 | 1% | 26579 | 25219 | -5% | 11970 | 14106 | 15% |
| 2012 | 122 | 196 | 38% | 1195 | 1296 | 8% | 5762 | 0 | 26536 | 25956 | -2% | 12000 | 13943 | 14% | |
Charlson Comorbidity Index – average of weighted CCI scores for each category of device, by country for the year 2011.
| Austria | England | Germany | Italy | Slovenia | ||
|---|---|---|---|---|---|---|
| Overall CCI scores | ||||||
| PM implants | 0.10 | 0.90 | 1.63 | 0.96 | 1.07 | |
| ICD implants | 0.58 | 1.32 | 2.50 | 1.27 | 1.52 | |
| PM implants | Acute myocardial infarction (AMI) | 1% | 1% | 9% | 5% | 6% |
| Congestive Heart Failure | 4% | 15% | 32% | 13% | 23% | |
| Diabetes | N/A | 17% | 20% | 11% | 22% | |
| ICD implants | AMI | 2% | 5% | 35% | 14% | 26% |
| Congestive Heart Failure | 54% | 60% | 91% | 73% | 63% | |
| Diabetes | 0% | 20% | 25% | 13% | 16% | |
Main reasons for difference in data in CIEDs uptake in 5 European countries (2008-2012).
| The reason for the difference in the data | A description |
|---|---|
No codes for PM replacement Some codes were valid only until 31 December 2010 Not specific enough (no codes for single chamber, dual chamber, BV/CRT, CRT_P or CRT_D procedures) | |
In Slovenia, coding is considered as an additional administrative burden | |
In Slovenia, an absolute indication is needed to receive the implant | |
Differences in political priorities Different economic developments across countries Differences in decision-making rules on including health care programmes in the basic benefit package |
Main reasons for difference in PM and ICD implants crude utilization rate (number of devices/100.000 inhabitants) across 5 European countries, 2008-2012.
| Pacemaker implants | |||||
|---|---|---|---|---|---|
| Austria | England | Germany | Italy | Slovenia | |
| 2008 | 67.3 | 60.0 | 87.2 | 74.3 | 29.9 |
| 2009 | 66.5 | 68.9 | 90.6 | 74.6 | 32.7 |
| 2010 | 70.5 | 75.7 | 94.5 | 75.1 | 31.2 |
| 2011 | 71.0 | 84.1 | 96.0 | 75.8 | 29.7 |
| 2012 | 72.4 | N/A | 96.4 | 77.6 | 32.7 |
| AGR average growth rate | 1.84 | 11.91 | 2.54 | 1.09 | 2.26 |