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Causes of differences in the uptake of cardiac implantation electronic devices in Slovenia in comparison to other countries Cover

Causes of differences in the uptake of cardiac implantation electronic devices in Slovenia in comparison to other countries

Slovenian Journal of Public Health
Volume 57 (2018): Issue 1 (March 2018)
By: ,   and    
Open Access
|Jan 2018
Figures & tables

Figures & Tables

Table 1

Main reasons for difference in data in CIEDs uptake in 5 European countries (2008-2012).

The reason for the difference in the dataA description
The use of Australian coding system valid until 21 December in Slovenia

  • 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)

Only a partial link between financing and DRG coding in Slovenia

  • In Slovenia, coding is considered as an additional administrative burden

No golden rule for the optimal crude utilisation rate

  • In Slovenia, an absolute indication is needed to receive the implant

Variations in relative indications, financial restrictions and other contextual factors across countries

  • Differences in political priorities

  • Different economic developments across countries

  • Differences in decision-making rules on including health care programmes in the basic benefit package

Table 1

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
AustriaEnglandGermanyItalySlovenia
200867.360.087.274.329.9
200966.568.990.674.632.7
201070.575.794.575.131.2
201171.084.196.075.829.7
201272.4N/A96.477.632.7
AGR*1.8411.912.541.092.26
ICD implants
AustriaEnglandGermanyItalySlovenia
200815.48.328.723.35.6
200916.79.732.324.17.7
201016.811.135.125.19.0
201118.311.537.326.18.5
201219.0N/A38.926.49.6
AGR*5.3911.487.903.1714.42

Source: MedtecHTA Report on Geographic variation in Utilisation Rates and Determinants of Access across European Countries for Medical Devices in Electrophysiology, 2015.

* average growth rate

* average growth rate

Table 2

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).

SloveniaAustriaAll UK EnglandGermanyItaly
YearEHRAHospitalsDiffEHRAHospitalsDiffEHRAHospitalsDiffEHRAHospitalsDiffEHRAHospitalsDiff
Pacemakers
20081100586-88%757076902%4057037734-8%9830089194-10%61300622202%
2009935652-43%79307500-6%39850427017%10217792215-11%6300062215-1%
20101153602-92%77127589-2%371944563618%10342394659-9%6340062202-2%
20111295604-114%781078701%382395054024%10695396013-11%6310062141-2%
20121333667-100%787079501%38770010656796403-11%61300620981%
ICDs
2008961037%110011040%74035086-46%2160020948-3%1800016554-8%
200911114523%12901157-11%507753766%2357422940-3%105001510030%
201010117643%12681176-8%517553443%2507124422-3%111001393320%
201114417417%18051195-51%540454671%2657925219-5%119701410615%
201212219638%119512968%576202653625956-2%120001394314%

[i] Source: MedtecHTA Report on Geographic variation in Utilisation Rates and Determinants of Access across European Countries for Medical Devices in Electrophysiology, 2015.

Table 3

Charlson Comorbidity Index – average of weighted CCI scores for each category of device, by country for the year 2011.

AustriaEnglandGermanyItalySlovenia
Overall CCI scores
PM implants0.100.901.630.961.07
ICD implants0.581.322.501.271.52
PM implantsAcute myocardial infarction (AMI)1%1%9%5%6%
Congestive Heart Failure4%15%32%13%23%
DiabetesN/A17%20%11%22%
ICD implantsAMI2%5%35%14%26%
Congestive Heart Failure54%60%91%73%63%
Diabetes0%20%25%13%16%

[i] Source: MedtecHTA Report on Geographic variation in Utilisation Rates and Determinants of Access across European Countries for medical Devices in Electrophysiology.

Figure 1

Crude utilisation rates of PMs and ICDs in 2011, in 5 European countries according to age group, gender and country.

DOI: https://doi.org/10.2478/sjph-2018-0001 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026
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Language: English, Slovenian
Page range: 1 - 9
Submitted on: Sep 6, 2016
Accepted on: Sep 8, 2017
Published on: Jan 5, 2018
Published by: National Institute of Public Health, Slovenia
In partnership with: Paradigm Publishing Services
Keywords:
cardiac implantation electronic devices,
Slovenia,
pacemaker,
automatic implantable cardioverter defibrillator,
accessibility,
health care technology,
MedtecHTA
Related subjects:
Medicine,
Clinical medicine,
Hygiene and environmental medicine

© 2018 Valentina Prevolnik Rupel, Renata Erker, Marko Divjak, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 57 (2018): Issue 1 (March 2018)
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