Same-day discharge among patients undergoing elective PCI: Insights from the VA CART program

Abstract Background Available data suggest same-day discharge (SDD) after elective percutaneous coronary intervention (PCI) is safe in select patients. Yet little is known about contemporary adoption rates, safety, and costs in a universal healthcare system like the Veterans Affairs Health System (VAHS). Methods Using data from the Veterans Affairs Clinical Assessment Reporting and Tracking (CART) Program linked with Health Economics Resource Center (HERC) data, patients undergoing elective PCI for stable angina between 10/1/07–9/30/16 were stratified by SDD vs. overnight stay. We examined trends of SDD, and using 2:1 propensity matching, we assessed 30-day rates of readmission, mortality and total costs at 30 days. Results Of 21,261 PCIs from 67 sites, 728 were SDD (3.9% of overall cohort). The rate of SDD increased from 1.6% in 2008 to 9.7% in 2016 (P  Conclusion VAHS has increasingly adopted SDD for elective PCI procedures, and this is associated with cost savings without an increase in readmission or mortality. Greater adoption has the potential to reduce costs without increasing adverse outcomes.