A two-step program of competitive bidding and physician feedback to reduce coronary angioplasty equipment costs

The major limitation of our study is that it addresses only 1 aspect of the delivery of interventional cardiology services, namely, equipment costs. We did not include catheterization laboratory overhead or hospitalization costs. We focused on equipment costs for 2 reasons. First, we have control over and accountability for the catheterization laboratory as a cost center. Second, the allocation of institutional overhead to catheterization laboratory activities involves a significant degree of arbitrariness. By focusing on the fairly narrow issue of equipment costs, we thought we could more clearly define the outcome of our interventions. Whether continued physician feedback will be useful in controlling costs in the era of new devices and novel anticoagulant agents remains to be seen.