Article Sidebar

Download
PDF

Main Article Content

Abstract

ABSTRACT
Introduction. In Cote d’Ivoire, cardiovascular surgery has been practiced since 1978. Since then, there has been a resurgence of interest in this surgery and the knowledge of its actual cost would help in health policy planning. The aim of this study is to specify the financial cost of cardiac and vascular surgery in our country. Methodology. This was a retrospective study from June 2009 to November 2010 carried out at the Abidjan Cardiology Institute and at Bouake Teaching Hospital from July 2021 to Octobre 2025. It was based on the invoices from patients who had undergone cardiac and vascular surgery without being part of a humanitarian care program. Thus, 124 operations considered representative of the scope of cardiac and vascular surgery offered at our two institutions were have being selected. We analyzed the average cost relating to the top 5 cost categories: hospitalization room, pharmacy, laboratory, operating room and supplements. Results. Invoices for single valve replacement (n=2), atrial septal defect (ASD) repair (n=4), modified Blalock-Taussig operation (n=2), patent ductus arteriosus (PDA) repair (n=6), open limb revascularization (n=47), embolectomy (n=5), pericardiectomy (n=1), pericardial drainage (n=28), permanent pacemaker (n=28) and vein stripping (n=1) were analyzed. The average cost of all the procedures was $ 5669 (extremes: $ 1696 – 9643). The proportion of this average cost by categories was variable: the pharmacy cost was $ 2863 (50.5%), the operating room cost was $ 1701 (30%), the hospitalization room cost was $ 794 (14%), the laboratory cost was $ 397 (7%) and the supplements costs were $ 141 (2.5%). The valve replacement was the most expensive surgical procedure with an average cost of $ 9643, while the vein stripping was the least costly surgical procedure with an average cost of $ 1697. About 107 patients (86.29%) were not covered by health insurance. Of these patients, only 50 (40,32%) obtained a reduction from 15.5% to 19.10 % of the cost of the procedure by the social department. Conclusion. Cardiac and vascular surgery is still very costly in our context. Pharmacy fees are the most expensive part of the patient's invoice. Social coverage is still almost non-existent for patients.
RÉSUMÉ
Introduction. En Côte d’Ivoire, la chirurgie cardiovasculaire est pratiquée depuis 1978. Face à l’intérêt croissant pour cette spécialité, l’évaluation de son coût réel est essentielle pour la planification des politiques de santé. Cette étude vise à préciser le coût financier de la chirurgie cardiaque et vasculaire dans notre pays. Méthodologie. Cette étude rétrospective a analysé 124 dossiers de patients opérés à l'Institut de Cardiologie d'Abidjan entre 2009 et 2010, et au CHU de Bouaké entre 2021 et 2025, hors programmes humanitaires. Les coûts ont été analysés selon cinq catégories : pharmacie, bloc opératoire, hospitalisation, laboratoire et suppléments. Résultats. Les factures ont été analysées pour les interventions suivantes : remplacement valvulaire unique (n=2), cure de communication interauriculaire (CIA) (n=4), opération de Blalock-Taussig modifiée (n=2), fermeture de persistance du canal artériel (PCA) (n=6), revascularisation chirurgicale des membres (n=47), embolectomie (n=5), péricardectomie (n=1), drainage péricardique (n=28), pose de pacemaker définitif (n=28) et éveinage (n=1).Le coût moyen global des procédures s'élevait à 5 669 $ (extrêmes : 1 696 $– 9 643 $). La répartition de ce coût moyen par catégorie était variable : la pharmacie représentait 2 863 $ (50,5 %), le bloc opératoire 1 701 $ (30 %), l'hospitalisation 794 $ (14 %), le laboratoire 397 $ (7 %) et les frais supplémentaires 141 $ (2,5 %). Le remplacement valvulaire était l'intervention la plus onéreuse avec un coût moyen de 9 643 $, tandis que l'éveinage était la moins coûteuse à 1 697 $. Environ 86,29 % des patients (n=107) ne bénéficiaient d'aucune assurance maladie. Parmi eux, seuls 50 patients (40,32 %) ont obtenu une réduction de 15,5 % à 19,10 % du coût de l'intervention via le service social. Conclusion. La chirurgie cardiovasculaire reste très onéreuse dans notre contexte, dominée par les frais de pharmacie. La couverture sociale demeure quasi inexistante, limitant l'accessibilité financière pour la majorité des patients.

Keywords

Cardiovascular Surgery, Financial Cost, Cote d’Ivoire Chirurgie cardiovasculaire, Coût financier, Côte d’Ivoire

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite
Meneas C, Sall F, Katche E, Abro S, Binate A, N’guesssan I, … Yangni-Angate H. (2026). Financial Cost of Cardiovascular Surgery in Côte d’Ivoire: A Retrospective Analysis of 124 Procedures: Coût Financier de la Chirurgie Cardiovasculaire en Côte d’Ivoire : Une Étude Rétrospective de 124 Procédures. HEALTH SCIENCES AND DISEASE, 27(Suppl 1), 103–107. https://doi.org/10.5281/zenodo.18393895
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. 1. Yangni-Angate KH, Meneas C, Diby F, Diomande M, Adoubi A, Tanauh Y. Cardiac surgery in Africa: a thirty-five-year experience on open heart surgery in Cote d’Ivoire. Cardiovasc Diagn Ther. 2016;6: S44-S63.
  2. 2. Sliwa K, Acquah L, Gersh BJ, Mocumbi AO. Impact of Socioeconomic Status, Ethnicity, and Urbanization on Risk Factor Profiles of Cardiovascular Disease in Africa. Circulation. 2016; 133:1199-208.
  3. 3. Livesay JJ. Cardiovascular disease in Africa. Tex Heart Inst J. 2007; 34:6-7.
  4. 4. Jamison DT, Feachem RG, Makgoba MW, Bos ER, Baingana FK, Hofman KJ. Disease and Mortality in Sub-Saharan Africa. 2nd edition. Washington (DC): World Bank, 2016.
  5. 5. Merle H, Yangni-Angate A, Delormas P. Thoracic Surgery in Côte d’Ivoire. Medical Africa 1961 ;1:25-33.
  6. 6. Metras D, Coulibaly A O, Ouattara K, Longechaud A, Millet P. La Chirurgie Cardiaque à l’Institut de Cardiologie d’Abidjan : à propos de 728 interventions dont 501 à Cœur ouvert. Cardiologie Tropicale 1984; N° Spécial, 81-7.
  7. 7. World Bank. Poverty in Sub-Saharan Africa: issues and recommendations. Africa Region findings, 1996;73. Washington, DC: World Bank.
  8. 8. Falase B, Sanusi M, Majekodunmi A, Ajose I, Idowu A, Oke D. The cost of open-heart surgery in Nigeria. Pan Afr Med J. 2013; 14:61.
  9. 9. Edwin F, Tettey M, Aniteye E, Tamatey M, Sereboe L, Entsua-Mensah K, Kotei D, Baffoe-Gyan K. The development of cardiac surgery in West Africa--the case of Ghana. Pan Afr Med J. 2011; 9:15.
  10. 10. Eze C, Ezemba N. Open Heart Surgery in Nigeria; indications and challenges. Tex Heart Inst J. 2007;34: 8-10.
  11. 11. Zaher Fanari, and William S Wein-traub. Cost-Effectiveness Of Trans-Catheter Versus Surgical Management of Structural. Heart Disease Cardiovasc Revasc Med. 2016; 17:44–7.
  12. 12. Mylotte D, Quenneville SP, Kotowycz MA, Xie X, Brophy JM, Ionescu-Ittu R, Martucci G, Pilote L, Therrien J, Marelli AJ. Long-term cost-effectiveness of transcatheter versus surgical closure of secundum atrial septal defect in adults. Int J Cardiol. 2014; 172:109-14.
  13. 13. Pasquali SK, Gaies MG, Jacobs JP, Gaynor W J, Jacobs M L. Center Variation in Cost and Outcomes for Congenital Heart. Surgery Cardiol Young. 2012; 22:796-9.
  14. 14. Pasquali SK, Sun JL, d'Almada P, Jaquiss RD, Lodge AJ, Miller N, Kemper AR, Lannon CM, Li JS. Center variation in hospital costs for patients undergoing congenital heart surgery. Circ Cardiovasc Qual Outcomes. 2011; 4:306-12.
  15. 15. Parrish MD, Pollock M, Gauthier N, Park J, Hobde B. Sources of variability in hospital costs of atrial septal defect repair. Am J Cardiol. 1998; 82:252–4.
  16. 16. Jacobs JP, O'Brien SM, Pasquali SK, Jacobs ML, Lacour-Gayet FG, Tchervenkov CI, Austin EH 3rd, Pizarro C, Pourmoghadam KK, Scholl FG, Welke KF, Mavroudis C. Variation in outcomes for benchmark operations: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2011; 92:2184-91; discussion 2191-2.
  17. 17. Pasquali SK, Jacobs ML, He X, Shah SS, Peterson ED, Hall M, Gaynor JW, Hill KD, Mayer JE, Jacobs JP, Li JS. Variation in congenital heart surgery costs across hospitals. Pediatrics. 2014;133:e553-60.
  18. 18. Reynolds MR, Magnuson EA, Lei Y, Wang K, Vilain K, Li H, Walczak J, Pinto DS, Thourani VH, Svensson LG, Mack MJ, Miller DC, Satler LE, Bavaria J, Smith CR, Leon MB, Cohen DJ; PARTNER Investigators. Cost-effectiveness of transcatheter aortic valve replacement compared with surgical aortic valve replacement in high-risk patients with severe aortic stenosis: results of the PARTNER (Placement of Aortic Transcatheter Valves) trial (Cohort A). J Am Coll Cardiol. 2012; 60:2683-92.
  19. 19. Sachs T, Pomposelli F, Hamdan A, Wyers M, Schermerhorn M. Trends in the national outcomes and costs for claudication and limb threatening ischemia: Angioplasty vs bypass graft. J Vasc Surg. 2011; 54:1021-31.
  20. 20. Navsaria PH, Nicol AJ. Video-assisted thoracoscopic pericardial window for pene-trating cardiac trauma. S Afr J Surg. 2006;44: 18-20.
  21. 21. Alpay L, Lacin T, Teker D, Okur E, Baysungur V, Kanbur S, Misirlioglu AK, Sonmez H, Yalcinkaya I, Kiyak M. A comparative cost analysis study of lobectomy performed via video-assisted thoracic surgery versus thoracotomy in Turkey. Wideochir Inne Tech Maloinwazyjne. 2014; 9:409-14.
  22. 22. Da Silveira WL, Bosco FA, Leite AF, Peixoto FA, de Sousa M, de Souza CC. Correction of Simple Congenital Heart Defects in Children and Adolescents Through Minithoracotomies. Arq Bras Cardiol. 2007; 88:358-62.
  23. 23. P Van Schil. Cost analysis of video-assisted thoracic surgery versus thoracotomy: critical review. Eur Respir J. 2003; 22:735–8.
  24. 24. Yim AP. Cost-containing strategies in video-assisted thoracoscopic surgery. An Asian perspective. Surg Endosc. 1996;10: 1198-200.
  25. 25. Kirby TJ, Mack MJ, Landreneau RJ, Rice TW. Lobectomy-video-assisted thoracic surgery versus muscle-sparing thoracotomy. A randomized trial. Thorac Cardiovasc Surg. 1995; 109:997-1002.
  26. 26. Edwin F, Tettey M, Aniteye E, Tamatey M, Sereboe L, Entsua-Mensah K, Kotei D, Baffoe-Gyan K. The development of cardiac surgery in West Africa--the case of Ghana. Pan Afr Med J. 2011; 9:15.
  27. 27. Joshi V, Kirmani B, Zacharias J. Thoracotomy versus vats: is there an optimal approach to treating pneumothorax? Ann R Coll Surg Engl. 2013; 95:61–4.

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.