found that stent-and-angioplasty procedures Show more A study released by the New England Journal of Medicine found that stent-and-angioplasty procedures are not as helpful as bypass surgery for heart patients with two or three blocked arteries. The study involved nearly 60000 patients with serious heart disease and calls into question the effectiveness of angioplasty saying it carries with it a higher risk of death in the long run and that those who underwent angioplasty were more likely to need another procedure within three years as opposed to those who had bypass surgery. The companies that make the stents used in angioplasties say the research does not include newer drug-coated stents that may produce better outcomes. Experts anticipate that the study will result in more bypass surgeries and fewer angioplasties being conducted which in turn will increase the cost of care since bypass surgery costs significantly more than angioplasty. This study is not the first to find an advantage to bypass surgery which has been seen as more effective over the long run because it creates a new pathway in the heart as opposed to simply opening up a diseased artery that may be prone to future blockages as is done in angioplasty. Source: John Hechinger The Growing Case for Heart Surgery The Wall Street Journal Mary 26 2005. 1. This article describes a classic cost effectiveness problem: one procedure is more expensive and appears to have better outcomes in the long run whereas the alternative treatment is less expensive but appears to have worse outcomes in the long run. Describe how you would determine which procedure is optimal from (a) the patients perspective (b) the hospitals perspective and (c) societys perspective. 2. Which variables might tip the scale in favor of one procedure versus the other? (For example is the quality of life the same after each procedure? Do older patients respond better to one or the other?) Show less