Valzania C, Torbica A, Tarricone R, Leyva F, Boriani G.
Implant rates of cardiac implantable electrical devices in Europe: A systematic literature review.
Health Policy 2015;
120:1-15. [PMID:
26632502 DOI:
10.1016/j.healthpol.2015.11.001]
[Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 10/02/2015] [Accepted: 11/02/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND
In recent years, indications for cardiac implantable electrical devices (CIEDs) have broadened; however, budget constraints can significantly impact patient access to these life-saving health technologies.
OBJECTIVE
To perform a systematic literature review on the implant rates of pacemakers, cardioverter-defibrillators, and cardiac resynchronization therapy devices in Europe over the last decade to provide insight into the possible reasons for differences across regions or countries.
METHODS
Four electronic databases were searched to find studies describing CIED implant rates in Europe. Fifty-eight studies were included.
RESULTS
An overview showed a recent rise in CIED implants, with large geographic differences. The ratio between the regions with the highest and lowest implant rates within the same country ranged between 1.3 and 3.4 for pacemakers and between 1.7 and 44.0 for defibrillators. The ratio between the countries with the highest and lowest implant rates ranged between 2.3 and 87.5 for pacemakers, between 3.1 and 1548.0 for defibrillators, and between 4.1 and 221.0 for resynchronization therapy devices. Implant rate variability appears to be influenced by health care, economic, demographic, and cultural factors.
CONCLUSION
Publications on CIED implant rates in Europe show a wide variability within and across countries, the determinants of which are only partially investigated. Policy making should improve regarding equity of access to better care.
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